Lanreotide (Somatuline LA®) – Reducing vomiting in terminal bowel obstruction

NICE recommendations, summary of meeting discussions, links to additional supporting docs etc.

GPs should ensure that they receive adequate support from Palliative Care team.

May 2013: Commissioning responsibility for cancer-related indications has been transferred to the NHS England SCG which does not support shared care prescribing for cancer-related treatments. Concern was expressed that if reclassified as Red (Hospital/Specialist only) patients would be unable to access treatment, particularly in rural areas.

Existing patients could be repatriated gradually with only new patients coming under a Red classification.

May 2013 N&W CCGs Drugs & Therapeutics Commissioning Group (D&TCG) Decisions:

Red (Hospital/Specialist prescribing only) for new patients starting treatment for cancer-related indications from 1st April 2013 onwards.

CCGs will seek reimbursement for any related Primary Care prescribing.

September 2013:

On-going discussion regarding impact on patients.

Recommended as Advice (GP prescribable at the request of Consultant/Specialist) for any patients already receiving treatment.

The TAG members agreed that regarding use for terminal bowel obstruction, the SCG’s determination to repatriate treatment to secondary care is inappropriate and that the treatment should remain in primary care.  Decision rests with commissioners (CCGs) to decide how the repatriation should be dealt with.

Local Acute Trusts have indicated that they would be happy to supply the treatment following a telephone conversation between clinicians and then reclaim the costs from NHS England if necessary.

N&W CCGs Drugs and Therapeutics Commissioning Group (D&TCG) supported the revised TAG recommendation.

January 2016:

The TAG noted NG 31 (December 2015)   Care of dying adults in the last days of life

This guideline aims to improve end of life care for people in their last days of life by communicating respectfully and involving them, and the people important to them, in decisions and by maintaining their comfort and dignity. It covers how to manage common symptoms without causing unacceptable side effects and maintain hydration in the last days of life.