• FCMS
  • Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
  • Rotherham Doncaster and South Humber NHS Foundation Trust
  • Nottingham and Nottinghamshire
  • South Yorkshire ICB

Using the MPD

CHANGE TO MPD - All NON-FORMULARY ITEMS ARE HIDDEN BUT CAN BE SHOWN BY CLICKING THE ARROW - Please see instructions Click Here

The harmonisation of place-based Traffic Light Drug List (TLDL) is underway with the long-term vision to have one TLDL for South Yorkshire.

All the medicines and products on the MPD have been agreed via either the Doncaster and Bassetlaw Area Prescribing Committee (APC) or the South Yorkshire Integrated Medicines Optimisation Committee (IMOC) so rationales may differ slightly as work to harmonise the place based TLDL continues. For all medicines and products agreed via the SY IMOC from February 2023 the below rationale applies. For all medicines and products previously agreed at Doncaster and Bassetlaw APC please follow this link

The traffic light status of medicines that have not been reviewed by IMOC or APC should not be assumed. Clinicians can seek advice from their ICB Medicines Optimisation team if requested to prescribe medicines that are not captured in place or SY TLDLs.

The Medicines and Product Directory (MPD) can be used to find a specific medicine or product, prescribing information and National and Local Guidance in three ways. 

You can select the following tabs situated within the grey banner or along the left hand side of the homepage:-

  • Therapeutic Section - has an arrow tab which when selected will provide a dropdown list of therapeutic sections and sub-sections - this option is particularly useful if you want to look at all medicine/products in a particular therapeutic section but can also be used to find a specific medicine/product.
  • Drug Index - this can be used to find a specific medicine/product and is in alphabetical order and will bring up all medicines / products beginning with the selected letter. All medicines and products in the directory will appear with their TLS colour coding alongside it. This displays the most relevant information about the medicine/product. If you require further information click on a medicine/product from this page and it will give you additional links, for example formulary products will give more information like strength/ form / pack size.
  • Search Box - this will bring up all entries where the medicine/product is listed for you to select, some medicines/ products have several indications and may appear in several sections/sub-sections, you would then choose the section dependant on the indication you are considering. You have to be specific with the search as sometimes the database does not recognise a search, you may need to simplify the search criteria in order to find the medicine / product.

Traffic Light Drug List Key (TLDL)

This indicates the TLDL status given by the NHS South Yorkshire Integrated Medicines Optimisation Committee (IMOC) or Doncaster and Bassetlaw Area Prescribing Group (APC). The TLDL status clarifies where a medicine or product should be prescribed in Primary and Secondary Care taking into account national and local guidance, monitoring requirements and any other specific information.

Grey, Red and Amber status give details of rationale to clarify the reason behind the status choice.

SY IMOC Traffic light status Criteria

Grey
The use of medicines/products in the grey list should not be initiated in South Yorkshire unless exceptional circumstances apply. Patients who are already prescribed medicines/products within the grey list should be reviewed and alternative treatment options considered, in line with most recent evidence.
Rationale/criteria;
1. There is a clear national guidance (e.g. NHS England Specialised Commissioning) to not routinely fund usage of the medicine/product.
2. There is clear national evidence (e.g. NICE ‘do not do’s’) to not routinely prescribe this medicine/product on the NHS.
3. Medicine/product of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns.
4. Medicine/products which are clinically effective but where more cost-effective products are available, including some products that have been subject to excessive price inflation. 
5. Medicines/products which are clinically effective but due to the nature of the product are deemed a low priority for NHS funding.
6. Medicines/products where clinical evidence is in development (e.g. NICE guidance) and awaiting final committee approval.
7. Evidence not evaluated. Local clinicians who wish to change Traffic Light Status complete application form.

8. Pathway in development

(Reference NHSE items that should not routinely be prescribed

Red
Initiation and ongoing prescribing of the medicine/product should be undertaken by secondary care/specialist.
Rationale/criteria;
1. Requires specialist assessment to enable patient selection, initiation, ongoing treatment and monitoring of efficacy, toxicity or adverse effects.
2. Specifically designated as “hospital only “by product licence or by DH as per drug tariff.
3. A new medicine/product or new indication for an existing medicine/product which needs specialist evaluation to be undertaken to establish place in therapy.
4. Hospital initiated clinical trial materials used in accordance with the trial protocol
5. Not listed in the current BNF or BNF / no prescribing information readily available.
6. Being used to treat a condition that is not suitable for primary care prescribing because of defined commissioning arrangements
7. Awaiting shared care guideline/guideline document

Amber – Shared care
Local shared care guidelines/protocols in place. Medicines/products that are initiated by a specialist but are suitable for primary care prescribing under a shared care agreement.
Rationale/criteria;
1. Requiring specialist assessment to enable patient selection and initiation of treatment, as defined within each shared care protocol (SCP).
2. Requiring a period of monitoring by the specialist (as defined within each SCP) to assess efficacy and safety of medication
3. Ongoing oversight of a specialist is required to assess continued efficacy and safety (e.g. long term monitoring of toxicity/degenerative conditions).
4. Medicine/product is subject to specific NICE guidance.

Amber G
Local or national Guidelines to support ongoing prescribing in primary care. Medicines/products that are must be initiated or recommended by a specialist but are suitable for primary care to continue and take over ongoing prescribing responsibility. The specialist to provide the primary care clinician with necessary information and support in order for treatment to be managed safely in primary care.
Rationale/criteria;
1) Requiring specialist assessment to enable patient selection and initiation of treatment.
2) Specialist to either;
a) titrate to a stable dose or
b) titrate to a point at which handover is suitable before primary care practitioners take over prescribing responsibility in line with locally agreed guidance clarifying shared prescribing and monitoring responsibility or
c) request primary care to initiate
Please refer to the ‘Comments’ within the TLDL for each individual product information / criteria

Green
These are medicines which are familiar and frequently used in General Practice. Primary care practitioners may take full responsibility for initiating and ongoing prescribing, subject to local formulary guidelines. Where there are local guidelines to support prescribers, these will be linked within the TLDL.
Due to the extensive number of green drugs, currently not all will be listed within the SY TLDL. If clarification is needed for a medicine not listed in the TLDL clinicians can seek advice from their place ICB Medicines Optimisation team.