Current News
September 2026
In line with the Milk Allergy in Primary Care (MAP) guidelines, Lincolnshire Community and Hospitals NHS Group’s Nutrition and Dietetic Service, together with Lincolnshire Integrated Care Board, has reviewed the milk allergy guidelines and pathway to improve the experience for babies and their parents.
Key updates include:
- Referral process improvements
- A newly established rapid access clinic – a virtual service designed to support babies within two weeks of referral.
The review highlighted that although Extensively Hydrolysed Formula (EHF) is suitable for around 90% of babies, significant quantities of Amino Acid Formula (AAF) were being prescribed across the county. The updated pathway simplifies prescribing for clinical colleagues, with SMA Althera Advance® (EHF) now the first-line choice on the Lincolnshire Formulary.
These changes aim to:
- Expedite appropriate care
- Improve quality of life and symptom resolution
- Enhance patient safety
- Provide better support for parents
The new referral process can be accessed by searching for the ‘Milk Allergy Lincs ICB’ template in SystmOne/EMIS or using the ‘ULTH Dietitian – Suspected Cow’s Milk Allergy’ form in Ardens. Please use this process going forward.
July 2026
Discontinuation of Clenil Modulite® and Atimos® Inhalers
Healthcare professionals are advised that the following inhalers are being discontinued in the UK:
- Clenil Modulite® (beclometasone) 50 micrograms
- Clenil Modulite® (beclometasone) 250 micrograms
- Atimos® (formoterol) 12 micrograms
The manufacturer has confirmed that the final UK supply of these products will take place in October 2026. Remaining stock is expected to be depleted by mid-November 2026, after which the products will no longer be available.
Action Required:
Practices are requested to identify patients currently prescribed these inhalers and arrange a review of their treatment at the next appropriate clinical opportunity. Reviews should be undertaken before October 2026, where possible, to minimise the risk of treatment disruption and ensure patients are established on a suitable alternative before stocks become unavailable.
Recommended Alternatives:
Patients prescribed Clenil Modulite® (beclometasone) should be reviewed for a switch to an appropriate alternative inhaled corticosteroid. In Lincolnshire, Soprobec® is the preferred first-line beclometasone inhaler brand and is bioequivalent to Clenil Modulite® making a direct switch from one to the other possible.
Patients prescribed Atimos® (formoterol) monotherapy should have their treatment reviewed in accordance with current national guidance (linked below) to determine whether ongoing formoterol monotherapy remains clinically appropriate, and if alternative treatment options should be considered.
Further Information:
For additional details regarding the discontinuation, including information provided by the manufacturer, please refer to the following document: Dear-HCP-Letter-Clenil-50mcg-250mcg-and-Atimos-Discontinuation.pdf
If you have any queries regarding this communication, please contact the Medicines Optimisation Team.
March 2026
NHS Derbyshire, Lincolnshire and Nottinghamshire ICBs (DLN Cluster) have issued a holding statement requesting that all practices and clinicians pause the local implementation of the updated NICE Guidance on the management of type 2 diabetes .
This slight delay in implementation is to enable the three ICBs to ensure that local guidance and care pathways are updated in line with the new guideline and to ensure that there is sufficient resources and services accessible in each area to ensure that adoption of the recommendations are feasible.
A cluster wide working group has been convened and clinicians from both secondary and primary care recruited to assist in this process.
We anticipate issuing a further update and an agreed implementation plan once this system level work has concluded.
3rd February 2026
The recent co-codamol medicines supply notification has compelled us to rationalise our prescribing of co-codamol across the system. The shortage is likely to last until June 2026 and this is an opportunity to review prescribing of long term opioids in patients with chronic non-cancer pain. This position statement outlines our commitment to implementing a safe, evidence-based approach to codeine tapering. We have produced guidance to aid clinicians in tapering co-codamol safely and effectively.
Please read the full LICB Co-codamol Shortage Position Statement here
The NHS Lincolnshire Codeine or Co-codamol Tapering Advice is available here
2025
Lincolnshire wound management product system-wide guidance on contact with commercial representatives
30th January 2025
The Lincolnshire wound management product system-wide guidance on contact with commercial representatives is a system wide collective adoption to direct all commercial representatives (also known as pharmaceutical representatives) contact for new, or products not included, in the Lincolnshire wound management formulary to the ULTH procurement team. Contact method is detailed in the guidance, via www.ulh.nhs.uk/about/trust/procurement/. ULTH procurement team will collate and pass requests on to the Clinical Procurement team. The outcomes of the Clinical Procurement team meeting will then be fed back to the Wound Management Formulary working group. This has been developed to help alleviate the frequent, and duplicated, commercial representative requests received across the system. To note - Commercial representatives and companies that support Trusts/Practices with training for products that are already included on the formulary/procured by the Trusts/Practices are still invited to contact Trusts/Practices through the usual channels. However, we ask that in this instance, the promotion of new products solely be undertaken through ULTH procurement.
Statement as below:
As a system we recognise the role that commercial representatives and companies play in assisting health practitioners to provide safe, effective, and economic products and services to the patients in their care. To ensure the relationship between commercial representatives, companies and the Trusts are transparent and well managed we have set out to mandate the use of a system wide approach. Commercial representatives will no longer be able to make ad-hoc contact or visits that have not been approved, or to ‘drop in’ on members of staff following a visit which they have been invited. The Procurement Governance lead and Procurement team at the ULTH Trust are now responsible for the operational management of all commercial representative and company contact for wound management products. The Procurement team at the ULTH Trust will forward all appropriate requests to the Clinical team who are responsible for standardisation and rationalisation of system-wide wound management products. Please direct all contact via the website - Procurement - United Lincolnshire Hospitals.
Commercial representatives and companies that support Trusts with training for products that are already included on the formulary/procured by the Trusts are still invited to contact Trusts through the usual channels. However, we ask that in this instance, the promotion of new products solely be undertaken through the above contact method.