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RED – specialist prescribing ONLY (not primary care)
“Prescribing and ongoing supply is normally undertaken by a consultant or other physician within a secondary care service, or by another commissioning arrangement.
Drugs that are Red on Traffic Light System (TLS) meet one or more of the following criteria:
1. Require specialist assessment to enable patient selection, initiation, ongoing treatment and monitoring of efficacy, toxicity or adverse effects.
2. Specifically designated as “hospital only“ either by product licence or by DoH
3. Not listed in the current BNF or BNFc.
4. Being used to treat a condition that is not suitable for primary care prescribing because of disease specific requirements, complexity or defined commissioning arrangements
For safety: All current RED drugs MUST be recorded in the GP patient record. 1) to be visible e.g. Summary Care Record (SCR) 2) to aid clinical decision making e.g. interactions”
AMBER – shared care
“Drugs that are initiated by a specialist but are suitable for GPs to continue ongoing prescribing. The specialist to provide the GP with necessary information and support in order for treatment to be managed safely in primary care. Shared care protocols (SCP) or treatment guidelines may be available.
1. Requiring specialist assessment to enable patient selection.
2. Requiring a period of monitoring by a specialist.
3. The initial prescription should normally be issued by the specialist unless the agreed SCP states otherwise”
GREY – not recommended
“The use of these drugs is not recommended. These drugs do NOT have any significant advantages over existing drugs within their therapeutic group.
Criteria for Classification:
1. Lack of data on effectiveness or safety compared with standard therapy.
2. Known increase in risk of adverse events compared with standard therapy.
3. Less cost-effective than current standard therapy”
4. There is a NICE recommendation that the drug should not be prescribed on the NHS for the condition specified
GREEN
These are medicines which are familiar and frequently used. Appropriate for initiation and ongoing prescribing in primary care. Due to the extensive number of green drugs, these not listed unless specific licensing to avoid confusion. These drugs will be listed in the current BNF or BNFc and recommended in the NICE Clinical Knowledge summaries
WARNING: If a drug is NOT rated on the TLS and unfamiliar then it may not have been reviewed for Rotherham
Many new, unlicensed or specialised agents may not have been subjected to review onto the TLS and should not be assumed to be amber or green. These may include (which are all RED):
- Cancer drug fund (NHSE)
- Specialist services / Tertiary - HIV, Hepatitis, Cystic Fibrosis (NHSE), antipsychotic depots, weight loss
- Biologicals - *mabs, *nibs etc. (ICB funded)
- Unlicensed medication & indications
South Yorkshire (SY) Integrated Care Board (ICB) Traffic Light Drug List (TLDL)
SY wide TLDL & Shared Care Protocols can be found here:
South Yorkshire Integrated Medicines Optimisation Committee * South YorkshireICB
This linked document is under development to ensure consistency across all four places in the ICB.
All new agents and NICE guidance will go through the SY ICB IMOC to be added onto this document.
Medicines on TLS across all four places are currently under review to create a harmonised SY wide TLDL.
Please read the definitions for colours on the SY document as these differ from Rotherham.
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Alcohol dependence - as per "ROADS - Rotherham Alcohol and Drug Service (Provided by With You)" Shared Care contract
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Items which should not routinely be prescribed (Download)