Wirral Health Economy joined Pan Mersey APC in January 2018. We are currently in an interim period of merging the two formularies. Please be aware there will be pathways and guidelines on the Pan Mersey APC website that were approved prior to Wirral joining Pan Mersey APC.

The guidelines in the table below have been approved via the local decision making committees and where relevant NICE and other national guidance has been taken into account.

Applications for new medicines 

For Cheshire & Wirral Partnership NHS Foundation Trust guidelines and policies relating to Mental Health, please visit; and scroll down the page to policies. Under category please select ‘Medicines Management’ and press search to show the list of the current CWP Medicines Management policies.

Individual Funding Requests

Medicines within tariff are the responsibility of hospital trusts to fund. There are a number of drugs excluded from the tariff (PbR Excluded drugs) where Primary Care are charged separately.

For PbR excluded drugs outside NICE guidance and local guidelines, individual funding requests will be considered by the Individual Funding Request Team.

Guideline Comment
Medicine across Wirral Health Economy  


Antibiotic Guidelines (Primary Care) Pan Mersey  

General Prescribing Advice 

Out-patient Parenteral Antimicrobial Therapy (OPAT) Service Referral Guidance




Oral Anticoagulant (VKA and DOAC) Guidelines for Prescribing Monitoring and Management

Anticoagulant (Oral) - High INR Pathway (under review)

Self-testing of INR – Patient/Practice Agreement (for Adaptation by Individual Practice) (under review)

Atrial fibrillation:

The Pan Mersey APC recommends in the absence of a specific clinical reason to select a particular DOAC, that the least costly DOAC is the first line DOAC for patients with non-valvular AF. Currently this is edoxaban. 


Apixaban Checklist (under review)

Dabigatran Checklist (under review)

Edoxaban Checklist (under review)

Rivaroxaban Checklist (under review)


Apixaban Leaflet 

Dabigatran Leaflet 

Edoxaban Leaflet 

Rivaroxaban Leaflet 

For other Patient Information Leaflets and Patient Alert Cards, please contact the individual manufacturers:

Apixaban – Pfizer: or phone 0800 7311736
Dabigatran – Boehringer Ingelheim: Order online or
phone 01344 742579
Rivaroxaban - Bayer: or phone 01635 563116

Edoxaban – Daiichi-Sankyo: or phone 08000285122


Apixaban Checklist (VTE and PE) (under review)

Dabigatran Checklist (VTE and PE) (under review)

Edoxaban Checklist (VTE and PE) (under review)

Rivaroxaban Checklist (VTE and PE) (under review)



Adapted from the Wirral Oral Anticoagulation Guidelines for Primary Care

Antidepressant Prescribing Guidance for Adults  
Anti-TNF Agents - Planned Conception in Inflammatory Arthritis  


Asthma Guideline in Primary Care - Adults

Asthma Treatment Guideline for GPs and Practice Nurses - Children <5 years old

Asthma Treatment Guideline for GPs and Practice Nurses - Children 5 years old and over

C Difficilie Information Sheet  
Contraceptive Guideline  


COPD Guideline for Inhaled Therapy

COPD Self Management Plan

COPD Clinician Rescue Pack Guidelines

COPD Patient Rescue Pack Leaflet

Top Tips Making a Difference in COPD

Chronic Consipation in Adults in Primary Care Guidelines  
Dementia - Behavioural and Psychological Symptoms (BPSD) Use of Antipsychotics  
Dexamethasone Injection  


Diabetes - Type 2 Diabetes Clinical Guideline

Diabetes - Blood Glucose Meters Guideline

Insulin Comparison and Identification Guide

Flash Glucose Monitor (FreeStyle Libre)



Template Primary Care Information

Template Initiation Information to Primary Care

Template Continuation Information to Primary Care

Template Patient Contract

Dyspepsia and Gastro Oesophageal Reflux Disease  
Gastro-Oesophageal Reflux Disease in Paediatrics  
Generalised Anxiety Disorder in Adults  
Gout – British Society for Rheumatology (BSR) Guideline  
Headache Pathway (Adults)  
High Strength Insulin Risk Minimisation Strategy  
Hypertension (Primary Uncomplicated) in Adults  
Hypersalivation Guidelines  
Insulin: Reducing Errors in Prescribing and Administration  
Lipid Lowering  
Liothyronine Containing Products Guideline  


Multi-compartment Compliance Aids (Blister Packs)  
Neuropathic Pain  


Guidelines for Managing Malnutrition in Adults in the Community

Wirral CCG Food First Patient Leaflet

Food First Diet Sheet

NSAIDs in Arthritis and Osteoarthritis in Adults  
Opioids and Gabapentinoids  
Oral Bisphosphonates for treating Osteoporosis  
Osteoporosis Management Guidelines  
Overactive Bladder Syndome (OAB) in Adults in Primary Care  
Paediatric Chronic Pain Guideline  
Palliative Care Symptoms guideline (NW Coast SCN)  
Parkinson's Disease  
Sequential Use of Biologics in Psoriasis Guideline  
Silk Garments  


Prescribing Guidelines for Stoma Appliances and Accessories

Stopping Over-Medication of People with Learning Disability, Autism or Both (STOMP)  
Summary Care Record: Minimising Harm From Missing Data  
Tapentadol Immediate Release Preparations  

Testosterone for Men with Secondary Androgen Deficiency

Guidance for Primary Care Prescribing

GP letter

Thickeners for Dysphagia GP Fact Sheet  
Unlicensed and Off-label Medicines  
Valproate: Safe Prescribing and Dispensing  
Vitamin D (Adults)


Please Note: Documents which are past their review date will only remain on the website if they are still clinically relevant. Some secondary care policies are also included here, where relevant to primary care and where there are links within in formulary chapters.