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Decision-Making Process

The Lancashire and South Cumbria Medicines Management Group (LSCMMG) provides a platform for the consensus decision-making process on the use of medicines across the Lancashire and South Cumbria NHS footprint.

The group makes recommendations to the eight Clinical Commissioning Groups (CCGs) for the use of medicines by way of horizon scanning for new drugs or receipt of requests from prescribers to use drugs where a funding decision has not yet been made. There are five local decision-making groups in Lancashire and South Cumbria who then decide whether to adopt the recommendations of the LSCMMG by considering their local needs. The five groups then feedback their decisions to the LSCMMG for inclusion on the website. 


Request for new medicine to be commissioned submitted to MLCSU following local prioritisation by one or more LSCMMG member organisations*

Request for new medicine is considered at the next LSCMMG meeting for prioritisation onto the work plan. Requests will be prioritised based on a number of criteria including but not exclusive to: Whether an existing position is already in place across Lancashire and South Cumbria, if the product is a genuinely novel treatment, if there are existing variations in use of the medicine across Lancashire and South Cumbria, if there is a need for local interpretation or clarification of existing NICE guidance, if the medicine is likely to impact on the wider patient care pathway or the use of the medicine could create a significant cost pressure or cost-saving.

Once a medicine has been prioritised for review  MLCSU will produce a draft “position statement” for consultation (with support from CCGs and involvement from relevant clinicians across Lancashire and South Cumbria if appropriate) and send to LSCMMG member organisations for a 5 week consultation period.

MLCSU collates and reviews comments and refines draft “position statement” if required within a maximum of 2 weeks from the closing date.

Final draft “position statement” considered by the next available LSCMMG meeting and recommendations agreed.

LSCMMG recommendations uploaded to the LSCMMG website within ONE week of LSCMMG meeting and LSCMMG member organisations informed that the final documents are available.

CCGs consider the LSCMMG recommendation within their local decision making groups for local adoption or adaption and inform LSCMMG (via MLCSU) of local action on recommendations once agreed.

MLCSU updates website with details of local decisions within ONE week of receiving the information from the CCG.



Requests may be generated through; the annual horizon scanning process for new medicines, IFRs considered to be service developments, individual requests from provider clinicians or individual CCGs, as a result of redesign of care pathways involving medicines, or for review of previous recommendations where there has been a significant change in clinical evidence or proposed pattern of use.

Requests prioritised for consideration by stakeholder considerations will take priority over those identified only through the horizon scanning process.

In some instances, medical devices which are available on NHS prescription may be prioritised for review by the LSCMMG. Where this happens the review process is adapted to take into account the unique challenges associated with assessing the safety, efficacy and usability of devices.

Medical Devices Review Process