About Specialist Medicines

A specialist medicine is defined as a medicine which has significant pharmacological complexity and/or rarity of use to make the prescribing of the medicine relatively uncommon in the community.

Patients receive a wide range of specialised care through hospitals in Northern Ireland. As care becomes more specialised, potential difficulties can arise in some cases in the transfer of care of patients from hospitals to the community when the prescribing of highly specialist medicines is involved.

Under the Regional Group on Specialist Medicines, a sub-committee of the NI Medicines Management Forum, a regional ‘traffic light’ system to manage the prescribing and supply of specialist medicines has been agreed. This is known as the Red Amber list.

The focus of the Regional Group is on the safety aspects of prescribing, supply and administration of specialist medicines relative to their management in secondary care, primary care or jointly.
Specialist medicines are identified as belonging to two categories as follows:

Red List Medicine: It is recommended that the prescribing responsibility should remain with the consultant or specialist clinician and that the supply of these medicines should be organised via the hospital pharmacy.

Amber List Medicine: It is recommended that the responsibility for prescribing be transferred from secondary to primary care with the agreement of an individual GP and when agreed shared care arrangements have been established.

It should be emphasised that the Red Amber List is advisory, and appearance of a medicine on the list does not imply endorsement of use, but rather a recommendation on prescribing responsibilities and whether or not the supply of a medicine should be organised through the hospital pharmacy network.

The HSC Board and Trusts are responsible for the implementation of the Red Amber List. Circular  HSS(MD)16/2003 refers.