Position Statements

Medical camouflaging products must only be initiated by a healthcare professional that specialises in skin colour matching and appropriate application techniques.
Please note: these products must only be continued in primary care if the patient’s GP believes issuing such a prescription will continue to significantly reduce the impact of the patient’s medical condition.

This guidance does not apply to the use of Sativex® (delta-9-etrahydrocannabinol and cannabidiol) oromucosal spray as an adjunct treatment for moderate to severe spasticity in multiple sclerosis

Denosumab as a second-line treatment option for the prevention of Osteoporotic Fragility Fractures

The Lancashire Medicines Management Group does not recommend the prescribing of e-Cigarettes

Where a proprietary biological medicine is indicated and biologically similar (biosimilar) medicine(s) to the reference product also exist the product with the lowest acquisition price should be used and charged to the commissioning organisation at the acquisition price (within licensed indications).

Product choices, including changes to treatment, for individual patients should be made following assessment by the responsible clinician taking into account patient choice.

To be read in conjunction with the LSCMMG guideline ‘Assessing suitability of strong opioid use’

Please refer to the LSCMMG inclisiran medicines entry for further information on use within Lancashire and South Cumbria - RAG rated 'Green (Restricted)'.

Prescribing request from out-of-area specialists to Lancashire GPs where there is an inconsistency with the recommended local and out-of-area colour classification

**This Guideline is currently under review. For further information please click here**

Please note: GPs and other primary care prescribers are under no obligation to act upon the advice issued by a private specialist. If the NHS prescriber receiving the request does not believe they have the competence to initiate or continue the recommended intervention a referral to an appropriate NHS specialist should be made. Patients are entitled to receive additional private care if this is provided separately from NHS care.

This position statement relates to the use of tapentadol MR for the following indications:

1. As a treatment option for intractable neuropathic pain in non-palliative care patients
2. As a treatment for nonspecific pain

Trans-anal Irrigation Systems are recommended for use within the Lancashire Health Economy for the treatment of Neurogenic Bowel Dysfunction and Non-Neurogenic Bowel Dysfunction including; chronic constipation and chronic faecal incontinence

**This Guideline is currently under review. For further information please click here**

This position statement covers all single-ingredient preparations of vitamin D prescribed within the Lancashire NHS health economy for the management of deficiency and insufficiency states. This document is not intended to provide full guidance for the use of vitamin D within the NHS in Lancashire. Local protocols should also be consulted where they exist.

For additional prescribing information see Vitamin D Prescriber Resources in our Clinical Resources section