The following documents have been developed for clinicians working within NCL. Documents which have passed their review date should be viewed as an archived document for information only. If you have any queries, please email admin.ncl-mon@nhs.net.
Documents
NCL ICB NHS Payment Scheme Policy 2024/25
NCL Interface Prescribing Guidance 2024/25
NCL ICB High Cost Drugs List 2024/25
Consensus on the Primary and Secondary Care Interface [NCL GP Website – login required]
Gastro-intestinal system
Cardiovascular system (inc. anticoagulation)
Direct Oral Anticoagulants (DOACs)
Choice of DOAC (Position Statement)
The documents below should be used to refer patients to their 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: https://www.medicines.org.uk/emc
DOAC Anticoagulation Referral
DOAC Counselling Checklist
DOAC GP Communication
DOAC Prescribing Support
Other
Summary of Antiplatelet Options in Cardiovascular Disease
Lipid management – medicines optimisation pathways
Stable angina prescribing guideline
Omega-3 Fatty Acids Position Statement
Guidance for the review of Omega-3 fatty acids
Guidance for the management of hypertriglyceridaemia
Low Molecular Weight Heparin (LMWH) prescribing guideline
Respiratory system
Adult asthma inhaler choice – Full guideline
Adult asthma inhaler choice – Quick reference guide
The NCL Acute and Chronic Management of COPD treatment guideline is approved by the NCL JFC as an interim measure, pending publication of the Pan-London COPD pathway.
Central nervous system
Lidocaine 5% Patch Position Statement
Co-proxamol Tablets Position Statement
Clozapine management for patients admitted to acute hospitals guidance
Cannabis-based medicinal products Position Statement
Cannabis-based medicinal products Patient Information
Valproate risk minimisation guideline
The “Adult ADHD: Additional information for prescribing in adults in primary care” document has been endorsed by C&I and BEH Mental Health Trust DTCs, and has been created to provide additional information to GPs when they consider requests to continue prescriptions for adult patients receiving stable doses for whom treatment was started by ADHD specialists working outside the NCL commissioned services (e.g., private organisations or overseas specialists).
The document can be found on the NCL GP website via the link below (note: you must login to view this page):
Adult ADHD: Additional information for prescribing in adults in primary care
Infections
NICE and UK Health Security Agency (UK HSA) have brought together their information on managing common infections into a summary table. The North Central London Medicines Optimisation Board (NCL MOB) support the use of the: Antimicrobial prescribing table (rcgp.org.uk).
Fluoroquinolones safe prescribing Position Statement
Treatment of Infections due to Multi-Drug Resistant Gram Negative Pathogens
From 1 June, the Health Services Laboratories (HSL) microbiology laboratory will apply new antimicrobial susceptibility result definitions recommended by the European Committee on Antimicrobial Susceptibility (EUCAST). While the letters ‘S’, ‘I’ and ‘R’ are retained, the definitions for the letters ‘S’ and ‘I’ have changed.
Communication to clinicians: Changes to antibiotic susceptibility reporting
Standard and High Dose Antibiotic Dosing Regimens
High consequence infectious diseases (HCID) centres in England have produced prescribing information for oral tecovirimat. This is hosted on the NCL MON website to support local clinicians and has been adapted to include supply information within NCL.
Tecovirimat prescribing information
Endocrine System
Endocrine System – Diabetes
Type 2 diabetes
Antihyperglycaemic agents for Type 2 diabetes
Insulin for Type 2 diabetes
Diabetes meters (finger-prick testing)
Endocrine – Continuous Glucose Monitoring (CGM)
Diabetes – Continuous Glucose Monitoring (CGM) for adults living with Type 1 diabetes
Diabetes NCL CGM prescribing pathway for adults living with Type 1 Diabetes
NCL CGM Pathway for adults living with Type 1 diabetes
NCL Continuous Glucose Monitoring (CGM) Devices Preferred Choices for Primary Care Prescribing
CGM upgrade implementation tools for adults living with Type 1 diabetes – for use by both Diabetes Specialist Clinics and General Practice
Appendix 2 CGM implementation tool for adults living with Type 1 diabetes – Freestyle Libre 2 Plus
Appendix 3 CGM implementation tool for adults living with Type 1 diabetes – Dexcom ONE+
CGM information sheets for adults living with Type 1 diabetes – General Practice, Community Pharmacy and Patients
CGM information for adults living with Type 1 diabetes – Community Pharmacy
CGM information for adults living with Type 1 diabetes – General Practice
CGM information for adults living with Type 1 diabetes – Patients
Obstetrics, gynaecology, and urinary-tract disorders
Musculoskeletal and joint disease
Eye
Borderline substances
Other
Herbal Supplements Position Statement
Homeopathy Position Statement
Dental Products Position Statement
Using Standardised Concentrations of Unlicensed Liquid Medicines in children Position Statement
Contact details for Medicines Enquiries in NCL (please read information on page 1 before making contact)
Information on biosimilar medicines is available on the below links for patients and healthcare professionals:
For Patients:
https://www.patients-association.org.uk/switchingtobiosimilars
For Healthcare Professionals:
https://www.england.nhs.uk/long-read/what-is-a-biosimilar-medicine/
https://www.sps.nhs.uk/articles/understanding-biological-and-biosimilar-medicines/