News summary

North East and North Cumbria (NENC) ICB are seeking NENC system-wide views on implementation of:

• NICE 30 day TA for daratumumab with bortezomib, lenalidomide and dexamethasone for untreated multiple myeloma – consultation closes 5pm on Monday 19th October
• NENC Formulary Working Group actions – September 2026 – consultation closes 5pm on Monday 2nd November
• NENC wound management formulary – consultation closes 5pm on Monday 2nd November

Comments are welcomed from across the system, including residents and patients of the NENC. Comments will be returned to NTAG and used to inform implementation of the decisions in NENC.

 All active consultations can be accessed at https://ntag.nhs.uk/consultations/.

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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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North East and North Cumbria (NENC) ICB are seeking NENC system-wide views on implementation of:

• Shared care protocol – Methylphenidate for patients within Paediatric Oncology – consultation closes at 5pm on Wednesday 14th October.
• NICE 30 day TA – mirdametinib for treating symptomatic and inoperable plexiform neurofibromas associated with neurofibromatosis type 1 in people 2 to 17 years – consultation closes at 5pm on Monday 19th October

Comments are welcomed from across the system, including residents and patients of the NENC. Comments will be returned to NTAG and used to inform implementation of the decisions in NENC.

 All active consultations can be accessed at https://ntag.nhs.uk/consultations/.

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Following the September meeting of the Clinical Guidelines and Pathways Group, North East and North Cumbria (NENC) ICB are seeking NENC system-wide views on implementation of the following:

• Tissue viability pathways – closing 2nd October
• Primary care guideline for management of insomnia – closing 2nd October
• Clinical pathway for prescribing and monitoring GnRH antagonists for endometriosis – closing 9th October
• Transanal irrigation pathway – closing 9th October
• Hypogonadism primary care guidelines – closing 9th October

Comments are welcomed from across the system, including residents and patients of the NENC. Comments will be returned to NTAG and used to inform implementation of the decisions in NENC.

 All active consultations can be accessed at https://ntag.nhs.uk/consultations/.

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North East and North Cumbria (NENC) ICB are seeking NENC system-wide views on implementation of NICE TAs published in July 2026. This consultation will run for four weeks and closes at 5pm on Tuesday 6^th October.

Comments are welcomed from across the system, including residents and patients of the NENC. Comments will be returned to NTAG and used to inform implementation of the decisions in NENC.

 All active consultations can be accessed at https://ntag.nhs.uk/consultations/.

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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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North East and North Cumbria (NENC) ICB are seeking NENC system-wide views on implementation of NICE TAs published in July 2026. This consultation will run for four weeks and closes at 5pm on Monday 21^st September.

Comments are welcomed from across the system, including residents and patients of the NENC. Comments will be returned to NTAG and used to inform implementation of the decisions in NENC.

 All active consultations can be accessed at https://ntag.nhs.uk/consultations/.

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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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