The Surrey Heartlands integrated care system Area Prescribing Committee (APC) approve the RMOC national shared care protocol with ‘local adaptations’.

This shared care protocol applies to adults aged 18 and over.

The local adaptation excludes gastroenterology indications from shared care, as it is considered a short-term treatment requiring hospital led treatment, and therefore a RED traffic light status, and this is endorsed by the Surrey Heartlands clinicians. All other indications listed in the shared care document will be considered AMBER

This shared care protocol also includes treatment of chronic inflammatory conditions where off-label use of ciclosporin is appropriate, including, but not limited to, the specialities and conditions described in Section 3 of the document.

These indications are off-label. The specialist must specify the indication for each patient when initiating shared care and clearly state when use is off-label.