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
or
| 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 | |
| Abdominal Hernia | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Adalimumab | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Adalimumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Alcohol Related | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Amitriptyline | Irritable bowel syndrome (IBS) 2nd line unlicensed | Green | n/a | Hertfordshire and West Essex ICB |
| Anal fissure | Anal fissure | n/a | Prescribing pathway | Hertfordshire and West Essex ICB |
| Bezlotoxumab | Clostridium difficile | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Bile salts malabsorption | Bile salts malabsorption | Amber initiation | Decision document | Hertfordshire and West Essex ICB |
| Biologic and Biosimilar Medicines | Where indicated | n/a | Patient information | Hertfordshire and West Essex ICB |
| Botulinum toxin type A | Focal spasticity, Hemi-facial spasm, Blepharospasm, Cervical dystonia, Frey’s syndrome, Chronic anal fissure, Dysphagia, Hirschsprung’s disease, Overactive bladder,Masseteric hypertrophy and temporomandibular disorders | Red | Prescribing guideline | Hertfordshire and West Essex ICB |
| Budesonide - rectal (Budenofalk) | Ulcerative colitis | n/a | Primary Care prescribing resource | Hertfordshire and West Essex ICB |
| Budesonide (Jorveza) | Inducing remission of eosinophilic oesophagitis | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Budesonide 9mg oral preparations | Crohn's disease, ulcerative colitis or microscopic colitis | Red | n/a | Hertfordshire and West Essex ICB |
| Cholecystectomy | n/a | Clinical policy | Hertfordshire and West Essex ICB | |
| Co-danthramer | Constipation - restricted to constipation in terminally ill patients of all ages | Green | Decision document | Hertfordshire and West Essex ICB |
| Colesevelam 2nd line | Diarrhoea associated with bile acid malabsorption | Amber initiation | n/a | Hertfordshire and West Essex ICB |
| Colestyramine 1st line | Diarrhoea associated with bile acid malabsorption | Amber initiation | n/a | Hertfordshire and West Essex ICB |
| Crohn's disease | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Darvadstrocel | Complex perianal fistulas in Crohn’s disease | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Dicycloverine | Irritable bowel syndrome (IBS) | Double Red | n/a | Hertfordshire and West Essex ICB |
| Diltiazem ointment 3rd line | Anal fissures | Green | n/a | Hertfordshire and West Essex ICB |
| Docusate sodium | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Dupilumab | Eosinophilic oesophagitis | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Etrasimod | Ulcerative Colitis - moderate to severe | Red | Prescribing pathway | 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 | |
| Filgotinib | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Galstones | n/a | Clinical pathways | South and West Hertfordshire | |
| Glyceryl trinitrate ointment 2nd line | Anal fissures | Green | n/a | Hertfordshire and West Essex ICB |
| Golimumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Heartburn and Indigestion PIL | Heartburn and Indigestion | n/a | Patient information | Hertfordshire and West Essex ICB |
| Hyoscine butylbromide | Irritable bowel syndrome (IBS) 1st line | Green | n/a | Hertfordshire and West Essex ICB |
| Inflammatory Bowel Disease (IBD) | n/a | Clinical pathways | East and North Hertfordshire | |
| Infliximab IV | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Infliximab IV | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Infliximab IV biosimilar | Diarrhoea or colitis associated with Immune Checkpoint Inhibitor therapy | Red | Decision document | Hertfordshire and West Essex ICB |
| Investigation of Persistent Lower GI symptoms where cancer is not suspected | n/a | Clinical pathways | South and West Hertfordshire | |
| Irritable Bowel Syndrome (IBS) | n/a | n/a | South and West Hertfordshire | |
| Ispaghula husk (Fybogel) | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Lactulose | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Laxido | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Liver Function Test (LFT) | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Loperamide | Diarrhoea | Green | n/a | Hertfordshire and West Essex ICB |
| Macrogol | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Mebeverine - immediate release (IR) | Irritable bowel syndrome (IBS) 1st line | Green | n/a | Hertfordshire and West Essex ICB |
| Mebeverine - modified release (MR) | Irritable bowel syndrome (IBS) | Double Red | n/a | Hertfordshire and West Essex ICB |
| Mesalazine - Octasa preferred 1st choice | Inflammatory bowel disease | Green | n/a | Hertfordshire and West Essex ICB |
| Mesalazine -Mezavant | Inflammatory bowel disease | Double Red | n/a | Hertfordshire and West Essex ICB |
| Methylnaltrexone bromide | Opioid induced bowel dysfunction | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Methylnaltrexone bromide | Constipation - opioid induced | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Mirikizumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Naldemedine | Constipation - opioid induced | Green | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Naloxegol | Constipation - opioid induced | Green | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Non-Alcoholic Fatty Liver Disease (NAFLD) | n/a | Clinical pathways | East and North Hertfordshire, South and West Hertfordshire | |
| Obeticholic acid | Primary biliary cholangitis (NHSE) | Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Omeprazole switch paediatric patient letter | Gastrointestinal disorders | n/a | Primary Care prescribing resource | Hertfordshire and West Essex ICB |
| Omeprazole switch PEG or NG patient letter | Gastrointestinal disorders | n/a | Primary Care prescribing resource | Hertfordshire and West Essex ICB |
| Opioid Induced Constipation | Opioid Induced Constipation | n/a | Prescribing pathway | Hertfordshire and West Essex ICB |
| Ozanimod | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Paediatric Abdominal Pain | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Paediatric Constipation | n/a | Clinical pathways | Hertfordshire and West Essex ICB | |
| Paediatric Diarhoea and Vomitting | n/a | n/a | Hertfordshire and West Essex ICB | |
| Peppermint oil | Irritable bowel syndrome (IBS) 1st line | Green | n/a | Hertfordshire and West Essex ICB |
| Phosphate enema (Cleen) | Constipation | n/a | Primary Care prescribing resource | Hertfordshire and West Essex ICB |
| Prednisolone | All indications - soluble tablet | n/a | Patient information | Hertfordshire and West Essex ICB |
| Prednisolone enteric coated | All indications | Double Red | n/a | Hertfordshire and West Essex ICB |
| Probiotics | Irritable bowel syndrome (IBS) | Double Red | NICE technology appraisal | Hertfordshire and West Essex ICB |
| Probiotics | Treatment or prevention of diarrhoea of any cause. | Double Red | Decision document | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) Stopping Or Reducing patient letter | Gastroprotection | n/a | Patient information | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) and Anticoagulants | Gastroprotection | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) and Antiplatelets | Gastroprotection | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) and Corticosteroids | Gastroprotection | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) and NSAIDS | Gastroprotection | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Proton pump inhibitor (PPI) deprescribing algorithm | Gastroprotection | n/a | Prescribing support document | Hertfordshire and West Essex ICB |
| Proton Pump Inhibitor (PPIs) -Appropriate Prescribing and Deprescribing- Q&A ECF 2025-26 | Gastroprotection | n/a | Prescribing support document | Hertfordshire and West Essex ICB |
| Proton pump inhibitors (PPI) - paediatric | Gastro-protection - paediatric | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Rifaximin | Hepatic encephalopathy | Amber initiation | Decision document | Hertfordshire and West Essex ICB |
| Risankizumab | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Risankizumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Selective serotonin reuptake inhibitors (SSRIs) | Irritable bowel syndrome (IBS) 3rd line unlicensed | Green | n/a | Hertfordshire and West Essex ICB |
| Senna | Constipation | Green | n/a | Hertfordshire and West Essex ICB |
| Sucralfate | Gastrointestinal ulcers | Double Red | Decision document | Hertfordshire and West Essex ICB |
| Tofacitinib | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Transanal irrigation | Bowel dysfunction | n/a | Prescribing guideline | Hertfordshire and West Essex ICB |
| Transanal irrigation products and quantities | Bowel dysfunction | n/a | Prescribing support document | Hertfordshire and West Essex ICB |
| Ulcerative colitis | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Upadacitinib | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Upadacitnib | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Ustekinumab | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Ustekinumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Vedolizumab | Crohn's disease - moderate to severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |
| Vedolizumab | Ulcerative colitis - moderate severe | Red | Prescribing pathway | Hertfordshire and West Essex ICB |