Author: Gavin Mankin

The medicines decisions made at the NENC Clinical Effectiveness and Governance (CEG) Subcommittee September 2026 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG at its September 2026 meeting and NICE Technology appraisals from the 1st June 2026 to 31^st July 2026.

The following new guidelines were approved and can be found at:

• NENC Contraception in Primary Care: Prescribing, troubleshooting and signposting – awaiting final version for publication on NTAG website.
• NENC Treatment of Constipation in Adults https://ntag.nhs.uk/wp-content/uploads/2026/09/NENC-Treatment-of-Constipation-in-Adults-Guideline-approved-Sep-2026.pdf
• NENC Melatonin Prescribing Support Information for children and adults https://ntag.nhs.uk/wp-content/uploads/2026/09/NENC-Melatonin-Prescribing-Support-Information-approved-Sep-2026.pdf

The following reviewed/updated guidelines were approved and can be found at:

• NENC ICB Cognitive Impairment Dementia Educational and Clinical support document – no changes made and review date extended for a further two years https://ntag.nhs.uk/wp-content/uploads/2026/09/NENC-ICB-Cognitive-Impairment-Dementia-Educational-and-Clinical-support-document-approved-Sep-2026.pdf
• North-East and Cumbria Adult Headache Guideline – technical update as NICE TA1172 Atogepant for treating migraine published in June 2026 and this has now been added to the formulary as a GREEN drug for this indication. https://ntag.nhs.uk/wp-content/uploads/2026/09/North-East-and-North-Cumbria-Adult-Headache-Guideline-Aug-2026.pdf
• Finerenone for treating chronic kidney disease in people with type 2 diabetes – technical update. Been reformatted and added in a section about potassium binders https://ntag.nhs.uk/wp-content/uploads/2026/09/NENC-Finerenone_CKD_type-2-diabetes_v7-approved-Sep-2026.pdf

The following guidelines and shared care guidelines have now been retired:

• Cellulitis Diagnosis and Management in Ambulatory Adults in primary care; Supporting Information – NENC ICB – has only been viewed about 25 times since May 2025. Information is available elsewhere and in more detail on NICE CKS.
• Paediatric transplant SCGs and Paediatric nephrotic syndrome SCG – Confirmed with NuTH that these paediatric SCGs no longer needed as treated as RED drugs so they can be retired. They were from former NoTGNC APC.

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The decision made with regard to these NICE 30 day TAs can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

• TA1178: Deuruxolitinib for treating severe alopecia areata
• TA1181: Aficamten for treating symptomatic obstructive hypertrophic cardiomyopathy

An updated version of the NENC Guidelines for the recognition and management of non-IgE cow’s milk allergy (CMA) in infants has been published at: https://ntag.nhs.uk/guidelines/

Updates are as follows:

• Page 8. Appendix 1 – deleted entry that Aptamil Pepti is suitable for use in vegetarians.

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Following the May 2026 and July 2026 NENC Clinical Effectiveness and Governance (CEG) Subcommittee meetings the following NICE TAs and guidelines were referred to the ICB Executive leadership group for approval given their cost impact:

• TA1128: Targeted-release budesonide for treating primary IgA nephropathy
• TA1140: Ruxolitinib cream for treating non-segmental vitiligo in people 12 years and over
• TA1142: Dupilumab for maintenance treatment of uncontrolled chronic obstructive pulmonary disease with raised blood eosinophils
• TA1143: Fezolinetant for treating moderate to severe vasomotor symptoms associated with menopause
• NG28: Type 2 diabetes in adults: management (update)
• TA1148: Sodium zirconium cyclosilicate for treating hyperkalaemia
• TA1152: Semaglutide for reducing the risk of major adverse cardiovascular events in people with cardiovascular disease and overweight or obesity

These have now all been approved by the ICB Executive leadership group and the NENC formulary has been updated accordingly. The May 2026 and July 2026 medicines decisions have been updated to reflect these decisions and can be found at: https://ntag.nhs.uk/meetings/decision-summaries/

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The medicines decisions made at the NENC Clinical Effectiveness and Governance (CEG) Subcommittee July 2026 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG at its July 2026 meeting and NICE Technology appraisals from the 1st April 2026 to 31^st May 2026.

The following new guidelines were approved and can be found at:

• Nil

The following reviewed/updated guidelines were approved and can be found at:

• NENC Agomelatine – Prescribing and Monitoring in Adults – Information for Primary Care – due review April 2026 – no significant updates https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-Agomelatine-Prescribing-and-Monitoring-in-Adults-Information-for-Primary-Care-v2-approved-July-2026.pdf
• NENC Position statement on the prescribing of branded generic medication – due review Feb 2026 – reformatted and no significant changes to content https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-Position-statement-on-Branded-Generics-v3-approved-July-2026.pdf
• NENC Regional Adult Headache Guideline – no significant updates. Updates as per update as per July 2026 CEG decision summary https://ntag.nhs.uk/wp-content/uploads/2026/07/North-East-and-North-Cumbria-Adult-Headache-Guideline-June-2026.pdf
• NENC Adult asthma and age 12 – 17 years guidelines – technical update Change of image and wording of ” Aerochamber Plus” to “Aerochamber Plus Flow-Vu” (the flow vu device creates a whistle if the patient inhales too fast. https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-Adult-asthma-guidelines-v2.2-approved-July-2026.pdf and https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-Asthma-Prescribing-Guidelines-for-Children-and-Young-People-12-to-17-years-approved-July-2026-v1.1.pdf
• NENC Guidelines for the recognition and management of non-IgE cow’s milk allergy (CMA) in infants – technical update –  Minor changes are on pages 8 & 9, where the brands available have been updated. https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-Guidelines-for-the-recognition-and-management-of-non-IgE-cows-milk-allergy-CMA-in-infants-v1.3-July-2026.pdf

The following reviewed and updated shared care guidelines were approved and can be found at:

• NENC Shared Care Protocol – Sativex for the treatment of spasticity in multiple sclerosis – technical update to recommend that a lower daily Sativex dose may be required in patients with moderate or severe renal impairment https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Methotrexate (oral and subcutaneous) for patients in adult services (excluding cancer care) – technical update as per change table on front page and July 2026 CEG decision summary. https://ntag.nhs.uk/shared-care-guidelines/

The following were also approved:

• NENC ICB Position Statement: Primary Care Prescribing of Vitamin B12 https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-ICB-Position-Statement-Primary-Care-Prescribing-of-Vitamin-B12-approved-July-2026.pdf
• NENC ICB Position Statement on Promethazine in Primary Care https://ntag.nhs.uk/wp-content/uploads/2026/07/NENC-ICB-Position-Statement-on-Promethazine-in-Primary-Care-approved-July-2026.pdf

The following shared care guidelines have had their review date extended:

• NENC Shared Care Protocol – Azathioprine and mercaptopurine within adult services (non-transplant indications) – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Ciclosporin (oral) for patients within adult services (non-transplant indications) – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Hydroxychloroquine for patients within adult services – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Leflunomide for patients within adult services – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Methotrexate (oral and subcutaneous) for patients in adult services (excluding cancer care) – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Mycophenolate mofetil and mycophenolic acid in adults (non-transplant indications) – extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Sulfasalazine for patients within adult services- extended to March 2027 https://ntag.nhs.uk/shared-care-guidelines/

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The medicines decisions made at the NENC Clinical Effectiveness and Governance (CEG) Subcommittee May 2026 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG at its May 2026 meeting and NICE Technology appraisals from the 1st February 2026 to 31^st March 2026.

The following new guidelines were approved and can be found at:

• NENC Guideline for the Recognition and Management of Faltering Growth in Infants and Young Children – https://ntag.nhs.uk/wp-content/uploads/2026/06/NENC-ICB-Faltering-Growth-Guideline-approved-May-2026.pdf
• NENC Guidance for Gynaecological Problems in Primary Care – awaiting final versions for publication on NTAG website.

The following reviewed guidelines were approved and can be found at:

• NENC Penicillin Allergy Assessment primary care for adult patients – no updates made 

The following reviewed and updated shared care guidelines were approved and can be found at:

• NENC Shared Care Protocol – Guanfacine for patients within adult services – technical updates as per change table on front page and May 2026 CEG decision summary. /https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Guanfacine for patients within children’s services – technical updates as per change table on front page and May 2026 CEG decision summary. /https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Lithium for patients within adult services – addition of cluster headache as an indication plus technical updates as per change table on front page and May 2026 CEG decision summary. https://ntag.nhs.uk/shared-care-guidelines/

The following were also approved:

• NENC Deciding Right Guidance and documentation

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An updated version of the NENC Oral Antipsychotics – Safe Prescribing Pathway has been published at: https://ntag.nhs.uk/guidelines/

Updates are as follows:

• 03: Annual Monitoring – link to CNTW Guidance on Managing the Effects of Psychotropic Drugs on Prolactin added.

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The medicines decisions made at the NENC Clinical Effectiveness and Governance (CEG) Subcommittee March 2026 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG at its March 2026 meeting and NICE Technology appraisals from the 1st December 2025 to 31^st January 2026.

The following new guidelines were approved and can be found at:

• NENC Oral Antipsychotics – Safe Prescribing – https://ntag.nhs.uk/wp-content/uploads/2026/03/NENC-Oral-antipsychotics-Safe-Prescribing-v1-approved-March-2026.pdf

The following reviewed guidelines were approved and can be found at:

• NENC Clozapine Supporting guidance for primary care – updates per March 2026 CEG decision summary https://ntag.nhs.uk/wp-content/uploads/2026/03/NENC-Clozapine-Supporting-guidance-for-primary-care-v2-approved-March-2026.pdf
• Finerenone for treating chronic kidney disease in people with type 2 diabetes – no updates made https://ntag.nhs.uk/wp-content/uploads/2026/03/NENC-Finerenone_CKD_type-2-diabetes_v6-approved-March-2026.pdf

The following updated guidelines were approved and can be found at:

• North East North Cumbria (NENC) ICB Medicines Committee Position Statement on Prescribing in Persistent Pain – updates per March 2026 CEG decision summary. Updated to reflect updated Opioids Aware guidance from Faculty of Pain Medicine https://ntag.nhs.uk/wp-content/uploads/2026/03/NENC-ICB-position-statement-non-palliative-care-use-of-opiates-update-Feb-2026.pdf
• NENC guideline for management of osteoporosis in primary care – updates per March 2026 CEG decision summary. https://ntag.nhs.uk/wp-content/uploads/2026/03/NENC-ICS-guideline-for-management-of-osteoporosis-in-primary-care-approved-Jan-2026-v9.1-updated-March-2026.pdf

The following new shared care guidelines were approved and can be found at:

• NENC Valproate SCG https://ntag.nhs.uk/shared-care-guidelines/

The following reviewed and updated shared care guidelines were approved and can be found at:

• NENC Shared Care Protocol – Amiodarone for patients in adult services – technical updates as per change table on front page and March 2026 CEG decision summary. https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Dronedarone for patients in adult services technical updates as per change table on front page and March 2026 CEG decision summary. https://ntag.nhs.uk/shared-care-guidelines/

The following shared care guidelines have had their review date extended:

• NENC Shared Care Protocol – Lithium for adult patients within mental health services – extended to July 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Azathioprine and mercaptopurine within adult services (non-transplant indications) – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Ciclosporin (oral) for patients within adult services (non-transplant indications) – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Hydroxychloroquine for patients within adult services – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Leflunomide for patients within adult services – – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Methotrexate (oral and subcutaneous) for patients in adult services (excluding cancer care) – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Mycophenolate mofetil and mycophenolic acid in adults (non-transplant indications) – extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Sulfasalazine for patients within adult services- extended to September 2026 https://ntag.nhs.uk/shared-care-guidelines/

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An updated version of the NENC Shared Care Protocol – Methylphenidate for patients within children’s services has been published at: https://ntag.nhs.uk/shared-care-guidelines/

Updates are as follows:

• Changes to wording in the introduction to provide place of methylphenidate in giggle incontinence
• Updated recommended initiation and maintenance doses in giggle incontinence
• Updated information on regular review by the specialist team for the indication of giggle incontinence
• Change from paediatric nephrology specialist to paediatric bladder and bowel specialist service throughout with reference to the indication of giggle incontinence

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Following approval at the January 2026 NENC Clinical Effectiveness and Governance (CEG) Subcommittee the following guidelines have now been published on the NTAG website:

• NENC Shared Care Protocol – Cinacalcet for the management of complex primary hyperparathyroidism in adults https://ntag.nhs.uk/shared-care-guidelines/

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The medicines decisions made at the NENC Clinical Effectiveness and Governance (CEG) Subcommittee February 2026 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

The following new shared care guidelines were approved and can be found at:

• NENC Shared Care Protocol – Atomoxetine for patients within adult services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Atomoxetine for patients within children’s services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Dexamfetamine for patients within adult services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Dexamfetamine for patients within children’s services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Guanfacine for patients within adult services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Guanfacine for patients within children’s services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Lisdexamfetamine for patients within adult services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Lisdexamfetamine for patients within children’s services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Methylphenidate for patients within adult services https://ntag.nhs.uk/shared-care-guidelines/
• NENC Shared Care Protocol – Methylphenidate for patients within children’s services https://ntag.nhs.uk/shared-care-guidelines/

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