Hertfordshire and West Essex ICB
Prescribing, Policies and Pathways
Prescribing, Policies and Pathways
The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more
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| Medicine / Guideline | Indication | RAG rating | Document type | Place |
|---|---|---|---|---|
| Abdomen and Pelvis CT to rule out Pancreatic Cancer | n/a | Decision document | South and West Hertfordshire | |
| Anastrozole | Familial breast cancer | n/a | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Bladder-Renal Cancer | Suspected | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Brain and Central Nervous System Cancers | n/a | Clinical pathways | East and North Hertfordshire | |
| Brain MRI for the exclusion of Brain and CNS Cancer | n/a | n/a | South and West Hertfordshire | |
| Breast Cancer - Suspected (Adults >16 years) | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Breast Screening Service | n/a | Patient information | Hertfordshire and West Essex ICB | |
| Cannabidiol (Epidiyolex®) | Tertiary care indication (NHSE) Suitable for shared care between tertiary and secondary care providers. Adjunctive treatment with clobazam for treating seizures associated with Dravet syndrome and Lennox-Gastaut syndrome (LGS) | Red | Decision document | Hertfordshire and West Essex ICB |
| Children's Cancer | n/a | Patient information | Hertfordshire and West Essex ICB | |
| Chlorambucil | Cancer indications | Red | n/a | Hertfordshire and West Essex ICB |
| Chlormethine gel | Mycosis fungoides-type cutaneous T-cell lymphoma (NHSE) | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Community Breast Pain | n/a | Clinical pathways | East and North Hertfordshire | |
| CT Request and 2WW Non-Specific Symptoms Referral Pathway | n/a | Clinical pathways | South and West Hertfordshire | |
| Dasatinib | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Delta-9-tetrahydrocannabinol [THC] and cannabidiol [CBD] spray (Sativex®) | Spasticity in multiple sclerosis (MS) | Red | Decision document | Hertfordshire and West Essex ICB |
| Denosumab Xgeva® | Prevention of skeletal-related events (NHSE) | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Erlotinib | All indications (NHSE) | Red | n/a | Hertfordshire and West Essex ICB |
| Etoposide | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Exemestane | Familial breast cancer | Amber initiation | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Faecal Immunochemical Test (FIT) process pathway for suspected Lower GI Cancer | n/a | Clinical pathways | Hertfordshire and West Essex ICB, South and West Hertfordshire | |
| Fulvestrant | Locally advanced or metastatic breast cancer | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Gynaecological Cancers - Suspected | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Haematological Cancer – Suspected | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Head and Neck Cancer - Suspected | n/a | Clinical pathways | East and North Hertfordshire | |
| Ibandronic acid 50mg | Prevention of skeletal events (pathological fractures, bone complications requiring radiotherapy or surgery) in patients with breast cancer and bone metastases. | Amber initiation | n/a | Hertfordshire and West Essex ICB |
| Ibrutinib | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Imatinib | All indications (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Lenalidomide | Multiple myeloma follicular lymphoma (NHSE) | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Letrozole | Familial breast cancer | Amber initiation | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Lower GI/Colorectal Cancer Suspected | n/a | Clinical pathways | East and North Hertfordshire, South and West Hertfordshire | |
| Lung Cancer - Suspected | n/a | Clinical pathways | East and North Hertfordshire, South and West Hertfordshire | |
| Lymphoedema Services – Specialist treatment in the private sector | n/a | Clinical policy | Hertfordshire and West Essex ICB | |
| Male LUTS | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Melphalan | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Mesna | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Methotrexate 10mg | Autoimmune disease | Double Red | n/a | Hertfordshire and West Essex ICB |
| Methotrexate 2.5mg | Autoimmune disease | Amber protocol | Prescribing guideline | Hertfordshire and West Essex ICB |
| Methoxsalen | Cancer, psoriasis | Red | n/a | Hertfordshire and West Essex ICB |
| Mitomycin | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Mitotane | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Nabilone | Intractable chemotherapy induced nausea and vomiting | Red | Decision document | Hertfordshire and West Essex ICB |
| Nintedanib | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Ovarian Cancer | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Palbociclib | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Peginterferon and ropeginterferon | Myeloproliferative neoplasms (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Pegvisomant | Acromegaly (NHSE tertiary centre only) | Red | Prescribing guideline | Hertfordshire and West Essex ICB |
| Pelvic Mass/Cancer | UI Physical Assessment | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Prostate Cancer - Suspected | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| PSA Pathway | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Raloxifene | Familial breast cancer | Amber initiation | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Reducing medicines waste in care homes - Care home staff | Care homes | n/a | Prescribing support document | Hertfordshire and West Essex ICB |
| Relugolix (Orgovyx) | Prostate cancer - hormone-sensitive | Amber initiation | Decision document | Hertfordshire and West Essex ICB |
| Relugolix (Orgovyx) | Prostate cancer - hormone-sensitive | Amber initiation | Prescribing support document | Hertfordshire and West Essex ICB |
| Relugolix (Orgovyx) | Hormone-sensitive prostate cancer | Amber initiation | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Ruxolitinib | Myelofibrosis (NHSE) | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Sarcoma - Suspected Cancer | n/a | Clinical pathways | East and North Hertfordshire | |
| Sativex® and other licensed cannabis -based medicinal products | Red | Decision document | Hertfordshire and West Essex ICB | |
| Sirolimus oral | Transplant rejection (prescribe by brand) NHSE for existing patients | Amber protocol | n/a | Hertfordshire and West Essex ICB |
| Skin Cancer Suspected - Pigmented Lesion/ Melanoma/ SCC/ BCC | n/a | Patient information | Hertfordshire and West Essex ICB | |
| Sodium clodronate | Bone pain, hypercalcaemia of malignancy | Amber initiation | n/a | Hertfordshire and West Essex ICB |
| Tacrolimus oral | Transplant rejection (prescribe by brand) NHSE for existing patients | Amber protocol | n/a | Hertfordshire and West Essex ICB |
| Tamoxifen | Familial breast cancer | Amber initiation | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Thalidomide | Cancer (NHSE) | Red | Decision document | Hertfordshire and West Essex ICB |
| Tioguanine | Leukaemia | Red | n/a | Hertfordshire and West Essex ICB |
| Tretinoin | Cancer (NHSE) | Red | n/a | Hertfordshire and West Essex ICB |
| Triptorelin as Decapeptyl SR®– Gonadorelin analogue of choice within licensed indications | All licensed indications | Amber initiation | n/a | Hertfordshire and West Essex ICB |
| Urology Cancer - Suspected (excluding Prostate) | n/a | Clinical pathways | Hertfordshire and West Essex ICB |