FOI 2026/1728

Under the Freedom of Information Act 2000, I request the following information regarding the prescribing of emollient treatments and dermatology access within your Integrated Care Board:

1. Formulary Evidence Base

Please provide copies of the most recent cost-effectiveness analyses, clinical reviews, or Equality Impact Assessments (EIAs) used to determine the current emollient formulary.

If these were produced by an Area Prescribing Committee (APC) on behalf of the ICB, please also provide the relevant minutes where these recommendations were adopted.

2. Clinical Criteria for Ceramide-Based Emollients

Please outline the clinical criteria and/or evidence reviews used to determine the inclusion or exclusion of ceramide-based emollients (such as CeraVe or similar) from routine primary care prescribing.

Please confirm whether considerations such as reduction in flare-ups and subsequent steroid use form part of any cost-effectiveness assessment.

3. Individual Funding Request (IFR) Data

For the last three financial years (2023/24, 2024/25, and 2025/26 to date), please provide:

• The total number of Individual Funding Requests (IFRs) submitted for non-formulary emollients or eczema treatments
• The number of these requests approved
• The number of these requests refused

4. Dermatology Referral Waiting Times

To help understand the interval between primary and secondary care, please provide the average waiting time (in weeks) for a patient to be seen following referral from a GP to a dermatology specialist for:

• Urgent referrals
• Routine referrals

Please provide this data for the most recent 12-month period available.

5. Evidence Review of Probiotic Interventions

Please clarify whether the ICB or its relevant APC has conducted a clinical review or evidence assessment regarding the use of specific probiotic strains for atopic dermatitis, specifically *Lactobacillus rhamnosusSP1 (DSM 22775) or *Lactobacillus reuteriBR03 (DSM 16604).

If no such review has been undertaken, please confirm this.

I would prefer to receive this information in electronic format. If any of the requested information is withheld, please specify the exemption(s) applied.

1. NHS Greater Manchester does not hold any cost-effectiveness analyses, clinical reviews, or Equality Impact Assessments (EIAs) specifically underpinning the current emollient formulary.

The current position is that there is no active emollient clinical guidance, as previous guidance has been retired. Emollient products are listed within the formulary; however, no supporting documentation or Area Prescribing Committee (APC) minutes have been identified.

The formulary is publicly available and can be accessed via the NHS Greater Manchester Medicines Management Group website https://www.greatermanchesterformulary.nhs.uk/default.asp

2. NHS Greater Manchester does not hold any formal clinical criteria or evidence reviews relating to the inclusion or exclusion of ceramide-based emollients (such as CeraVe) from routine primary care prescribing.

Ceramide-based emollients are not included within the current formulary. No evidence has been identified to indicate that specific considerations such as reduction in flare-ups or steroid use formed part of a local cost-effectiveness assessment.

3. A search has been conducted on the NHS GM IFR database (Blueteq) for the last three financial years (2023/24, 2024/25, and 2025/26 to date) and can respond as follows.
   • The total number of Individual Funding Requests (IFRs) submitted for non-formulary emollients or eczema treatments = 0
   • The number of these requests approved = 0
   • The number of these requests refused = 0

4.

5. NHS Greater Manchester Medicines Optimisation has not conducted a clinical review or evidence assessment regarding the use of Lactobacillus rhamnosus SP1 (DSM 22775) or Lactobacillus reuteri BR03 (DSM 16604) for atopic dermatitis.

A search of local records has not identified any such assessment.