Current Adult Red Amber Green (RAG) List
On this page you will find our RED AMBER GREEN DNP/GREY list for adults (scroll down to see the list).
Please check the paediatric RAG list for those drugs/indications which are specific to use in children only.
RAG list entries may be subject to a lag period to allow for implementation by Trusts/CCGs. Please check with your individual Trust or CCG.
If an indication is not stated then the designated status relates to licensed indications only.
Exceptions may arise and it is to be remembered that the RAG list is advisory and cannot be expected to include every possible use of every drug. Primary care prescribers and specialist teams are encouraged to discuss individual patient circumstances and consider where prescribing is best managed taking into account monitoring requirements, drug interactions, frequency of routine patient visits to the specialist and the specialist nature of the condition being treated. Clinical judgement should be used to arrive at the most reasonable outcome. However, if it is not possible to reach a consensus or a specific issue has arisen, please submit an application to the Clinical Reference Group to assess or re-assess the RAG status.
Please read the Guidelines on Defining Red, Amber, Green, DNP, and Grey Status for further detail on assigning a RAG status prior to submitting any queries or applications to GMMMG.
In line with NHS England guidance, GM do not routinely support prescribing for conditions which are self-limiting or amenable to self-care. For further details see GM commissioning statement.
Red Amber Green Classifications
| Classification | Guidance |
|---|---|
| Red | Drugs considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy or specialist service. This may include arranging for supply via a home care company. |
| Amber | Drugs considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy or specialist service. This may include arranging for supply via a home care company. |
| Green following specialist initiation | Drugs considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy or specialist service. This may include arranging for supply via a home care company. |
| Green following specialist advice | Drugs that are suitable for initiation by primary care following written or verbal advice from a specialist service. Little or no monitoring is required. |
| Green | Drugs that are suitable for initiation and ongoing prescribing within primary care. |
| Formulatory status | |
| DNP | Products which are not recommended for prescribing in any setting. “Do Not Prescribe” status may relate to a specific medicine, or to prescribing for a particular indication. This is in addition to all medicines with a “not NHS” or “Drugs of Low Clinical Value” classification in the BNF, and those medicines with a NICE “Do not do” recommendation. |
| Grey | Products which are not suitable for routine prescribing but suitable for exceptional use in a defined patient population. Prescribers should ensure that more suitable alternatives have been considered and ruled out as not being appropriate before recommending or prescribing a medicine with a GREY list status. In these cases a RAG of RED, AMBER or GREEN will also be assigned to clarify in which care setting prescribing responsibility lies. |
Criteria for inclusion on DNP/grey lists:
- Criterion 1: Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns.
- Criterion 2: Products which are clinically effective but where more cost-effective products are available, including products that have been subject to excessive price inflation.
- Criterion 3: Products which are clinically effective but, due to the nature of the product or condition being treated, are deemed a low priority for NHS funding.
| Drug (proprietary examples) | BNF chapter | Indications and rationale | Formulary drug | RAG status | Information | Responsible commissioner | Date added |
|---|---|---|---|---|---|---|---|
| Reallylongdrugname | 5 | HIV medicines | Yes | Red | NHSE |