Integrated Care Protocols (ICPs)

The medicines listed below are designated within the Trust formulary as requiring Specialist initiation, and subsequent prescribing in accordance with an ICP – Integrated Care Protocol. These drugs are coded within the Formulary as amber.

Specialist initiation might be required because of complex assessment and diagnostic criteria for the disease being treated, or the medication used might be unfamiliar to GPs. As the prescriber of a medication legally assumes responsibility for the drug additional prescribing support might be required for continued prescribing.

An Integrated Care Protocol can assist in the seamless transfer of patient treatment from secondary care to general practice, as it provides information on the drug, together with guidance on the prescribing and monitoring responsibilities.

The timing of the transfer of prescribing responsibility for each medication is described in its specific ICP, but, as a principle, prescribing should be retained by the specialist until the dose is stable between hospital visits.

ICPs in place within the trust and agreed with our local ICBs are shown below. Additional ICPs may be found on Shropshire, Telford and Wrekin website Home – NHS Shropshire, Telford and Wrekin (shropshiretelfordandwrekin.nhs.uk) .

Copies of the agreement should be printed for each party – Specialist and GP – to agree, sign and retain.

Drug Name

Indication

Amiodarone Severe Rhythm Disorders
Atomoxetine ADHD
Azathioprine and Mercaptopurine Patients within adult services (non-transplant indications)
Ciclosporin Patients within adult services (non-transplant indications)
Cinacalcet Primary Hyperparathyroidism
Dexamfetamine ADHD – Adults and Children/Adolescents have separate documents
Dronedarone Atrial Fibrillation
Hydroxychloroquine Dermatology/Rheumatology
Leflunomide Rheumatology
Liothyronine Primary Hyperthyroidism in combination with Levothyroxine
Lisdexamfetamine ADHD – Adults and Children/Adolescents have separate documents
Lithium Mania and hypomania
Lurasidone Schizophrenia
Methotrexate Gastroenterology, Rheumatology, Dermatology
Methylphenidate ADHD in Children and Adolescents
Mycophenolate mofetil Patients within adult services for non-transplant indications
Quetiapine Patients over 65 with Parkinson’s Disease
Rivastigmine Patients over 65 with Parkinson’s Disease
Sodium Valproate Epilepsy and Bipolar disorder
Sulfasalazine Gastroenterology, Rheumatology, Dermatology

Out of date documents are under review, but can continue to be used until a replacement ICP is agreed and adopted.

Decisions about the NHS provision of Drugs and other Treatments.

As per s34(2)(a) of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 the Trust is compliant with the NICE recommendations in relation to the commissioning of drugs and treatments (More Information).

The NICE recommendations for any particular drug can be found on their website at: https://www.nice.org.uk/guidance

However, do you not have access to the internet and wish to come in and view these, you can contact the Trust and arrange an appointment to come in.