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Prescribing Guidance
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Prescribers are encouraged to only prescribe medicines that are listed in formulary.   Where medicines are listed without medicinal forms or strengths, any form may be prescribed.  If a medicine is not listed, prescribers should use an equivalent listed medicine.  Professional judgement should be used when deciding on any deviations from formulary e.g. patient stabilised on a particular medicine.  Medicines that are listed as ‘do not prescribe’ should only be prescribed in exceptional circumstances.  Exceptions may arise and it is inevitable that the formulary will not include every possible use of every drug.  Clinical judgement should be used to arrive at the most reasonable outcome.  Advice and support can be taken from your local medicines optimisation team on prescribing outside of the formulary.  The formulary is applicable to new initiations and should meet the needs of the majority of patients. 

The process for Individual Funding Requests for ICB commissioned medicines is explained on the ICB web site: https://www.lancashireandsouthcumbria.icb.nhs.uk/our-work/individual-funding-requests-ifr  

The process for Individual Funding Requests for NHSE commissioned medicines is explained on the following web site:  https://www.england.nhs.uk/commissioning/spec-services/key-docs/#ifr 

Representatives from pharmaceutical companies should use the following email address: mlcsu.lscformulary@nhs.net  

Requests for updates to the formulary should be via the following email address: mlcsu.lscformulary@nhs.net

The formulary lists medicines that have been approved for use within Lancashire and South Cumbria; it employs a ‘RAG’ rating system to indicate prescribing status.  A brief summary of the RAG ratings are below: 

 Appropriate for initiation and ongoing prescribing in both primary and secondary care.  

 Appropriate for initiation and ongoing prescribing in both primary and secondary care provided additional criteria specific to the medicine or device are met, or the medicine is used as described the relevant LSCMMG pathway.  

 Medicine is supplied by the hospital for the duration of the treatment course. Primary care initiation or continuation of treatment is not recommended unless exceptional circumstances and/or a GP with specialist knowledge.  

 Suitable for prescribing in primary care following recommendation or initiation by a specialist.  

 Suitable for prescribing in primary care following recommendation or initiation by a specialist under a shared care agreement.  

 Suitable for prescribing in primary care following recommendation or initiation by a specialist under a shared care agreement and enhanced service arrangements.   

 Do not prescribe: NOT recommended for use by the NHS in Lancashire and South Cumbria.   

 Medicines which have not yet been reviewed or are under the review process. GPs and specialists are recommended not to prescribe these drugs.  

 Refer to local guidance.