Medicine Pathways, Guidelines And Position Statements

Cardiovascular system (inc. DOACs)

Direct Oral Anticoagulants (DOACs)

The documents below have been agreed by the stakeholders working in North Central London and have been approved by the NCL Joint Formulary Committee (NCL JFC). They should be used to refer appropriate patients to his/her local anticoagulation clinic for initiation of anticoagulation.
Where appropriate, local anticoagulation clinics should add their own contact details on the relevant paperwork (i.e. referral proformas, notification and transfer of care forms)
Please note that these documents may be updated intermittently. Users are also reminded that the prescribing guidance is not definitive and that other sources such as the electronic medicines compendium (SPCs) should be used for the most recent drug information. This can be found at the following link: http://www.medicines.org.uk/emc/default.aspx

Other

Summary of Antiplatelet Options in Cardiovascular Disease
Sacubitril valsartan for heart failure position statement (NEL and NCL joint positioning)
Statin prescribing & lipid modification guideline
Stable angina prescribing guideline
Omega-3 Fatty Acids Position Statement

Respiratory system

Asthma adult inhaler choice

 

The following COPD guideline has been produced by the Camden, Haringey and Islington Responsible Respiratory Prescribing Group and applies to organisations that are constituent members. It has not been ratified by the NCL Joint Formulary Committee and does not apply to all organisations in NCL.

Stable COPD Treatment Guideline

Endocrine system

Type 2 diabetes

Antihyperglycaemic agents for Type 2 diabetes
Insulin for Type 2 diabetes

 

Diabetes meters (finger-prick testing)

Blood glucose and Ketone monitoring

 

Diabetes meters (flash glucose monitoring)

See ‘Flash glucose monitoring‘ page

 

Other

Liothyronine position statement

Endocrine system – Flash glucose monitoring

Use of Freestyle Libre in North Central London
Forms – for use by diabetes specialists
Information sheets – for patients and primary care
Training materials
Competencies

 

Out of region implementation advice

Different CCGs across London and Hertfordshire have implemented Libre differently; to identify which CCG is responsible for a given patient, enter the patient’s registered GP practice name or postcode into https://openprescribing.net/practice/

RegionEligibilityBlueteq formHospital prescribingLibre reimbursement for TrustsPaperworkManual outcome data collection
North Central London
(Camden, Barnet, Enfield, Haringey, Islington CCGs)
LPP/LDCN criteriaYes (initiation [inc. existing self-funders] and continuation [6m])New: First 6 months only

Eligible self-funders: Nil
YesPatient-prescriber agreementNo - data collection built into NCL Blueteq form
North West London
(Brent, Central [Westminster], Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow, West [London Borough of Kensington and Chelsea and Queen’s Park and Paddington])
LPP/LDCN criteriaYes (initiation [inc. existing self-funders])First 2 months onlyNoPatient-prescriber agreement

Request for short term prescribing

Request for long-term prescribing
Yes
North East London
(Newham, Tower Hamlets, Waltham Forest, Barking and Dagenham, Havering, Redbridge, City and Hackney)
N,TH,WF: LPP/LDCN criteria

B&D,H,R: LPP/LDCN criteria

C&H: LPP/LDCN criteria
WF only: In progress

Others: No
First 2 months onlyNoPatient-prescriber agreement

Request for short term prescribing

Request for long-term prescribing
Yes
South East London
(Bexley, Bromley, Greenwich, Lambeth, Lewisham, Southwark CCGs)
LPP/LDCN criteriaNoNew: First 6 months only

Eligible self-funders: Nil
YesPatient-prescriber agreement

Request for long-term prescribing

SEL APC Position Statement

SEL guidance and resources
Yes
South West London
(Croydon, Kingston, Wandsworth, Richmond, Sutton, Merton)
LPP/LDCN criteriaNoFirst 2 months onlyNoPatient-prescriber agreement

Request for short term prescribing

Request for long-term prescribing
Yes
Hertfordshire
(Herts Valleys, East & North Herts CCGs)
Herts specific criteriaYes
(initiation and every 6 months)
AllYesPatient-prescriber agreement (adults)

Patient-prescriber agreement (paeds)
Yes