The Royal Pharmaceutical Society published guidance last week in response to “some CCGs” looking to reduce the routine prescribing of medicines that have been assessed to be “readily available for over-the-counter (OTC) purchase”.

It came three weeks after Dudley CCG stopped the routine prescribing of “self-care medicines” – including paracetamol and headlice lotion. A poster (below) produced by the CCG states that “prescriptions for self-care medicines are no longer available from your GP” and instead encourages patients to “buy these [medicines] over the counter at your local pharmacy”.

From 1 August prescriptions for certain medicines available over the counter in pharmacies & from shops & supermarkets will stop #HelpUrNHS pic.twitter.com/kiCOrKR9NM

— Dudley CCG (@DudleyCCG) August 1, 2017

So are CCGs within their rights to tell the public that prescriptions of OTC medicines are now off-limits?

CCGs “don’t have that power”

David Reissner, senior healthcare partner at law firm Charles Russell Speechlys LLP, stresses that CCGs “do not have the power to say what GPs can or cannot prescribe”.

“CCGs are legally entitled to try to influence prescribing, but they cannot insist that GPs cease prescribing medicines that can be bought over the counter,” he tells C+D.

“GPs must make their decisions on the basis of their contracts, which require them to prescribe treatment if this is clinically appropriate.”

Mr Reissner echoes concerns raised by GP Azeem Majeed earlier this month when he says: “In my opinion, a statement by a CCG to the public saying that self-care medicines are no longer available from their GP is not lawful.”

“GPs could be sued”

It begs the question: what would happen if GPs followed CCGs’ recommendations to their logical conclusion, and refused to prescribe these OTC drugs and treatments?

“A GP who refused to prescribe because the required item could be bought over the counter would probably be in breach of contract, and could be sued or made the subject of a complaint under the NHS complaints procedures,” Mr Reissner adds.