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More CCGs scrap OTC and gluten-free products from prescriptions

CCGs: 77% of respondents to public consultation agreed with halting gluten-free food prescriptions
CCGs: 77% of respondents to public consultation agreed with halting gluten-free food prescriptions

East and North Hertfordshire and Herts Valleys are the latest CCGs to “limit routine prescribing” for minor ailments and scrap gluten-free products from prescriptions.

At a public meeting last week (October 12), the clinical commissioning groups (CCGs) decided to introduce a number of changes to healthcare services in the county, to “make the best use of [NHS] money and resources” and “encourage people to live healthier lives”.

Once the new prescribing policy is implemented, people will need to buy medicines for minor ailments “themselves from pharmacies or shops”, East and North Hertfordshire CCG said in a statement on its website.

The changes come after a 10-week consultation that received “thousands” of responses from members of the public. It found 89% are in favour of scrapping funding for minor ailments treatment, while 77% agreed with halting gluten-free food prescriptions, the CCGs said.

“Glib” information

As part of the consultation, the CCGs claimed "a packet of 16 paracetamol tablets costs less than 25p in a pharmacy or supermarket, but paracetamol tablets on prescription cost at least five times more to the NHS”.

Responding at the time, Hertfordshire local pharmaceutical committee (LPC) said this example is “misleading” and “could be considered glib”, as the price will vary depending on the retailer and brand.

The prescribing policy risks patients losing face-to-face contact with a healthcare professional, as they “may start buying all their over-the-counter medicines from a supermarket shelf". This could result in symptoms for conditions being ignored – with “catastrophic consequences”, the LPC stressed in a statement on its website last month.

Five areas of concern

The LPC gave five areas the CCG “must consider” before implementing the “one size fits all” prescribing policy, including providing tools to help community pharmacy, such as an “appropriate referral system for fast tracking patients to the right place at the right time”.

“Selling an over-the-counter medicine in pharmacy often requires advice, support and time with pharmacy staff and is not just a case of increasing a pharmacy’s revenue,” the LPC added.

It also recommended commissioning a “common illnesses service”, as well as a self-care promotional campaign.

In addition, the LPC is “concerned that a blanket ‘no’ to gluten-free prescribing is discriminatory and open to challenge”, it said.

However, the gluten-free product list “should be restricted” based around each patient’s needs, it conceded.

Hertfordshire LPC executive officer Helen Musson told C+D today (October 18) that the organisation is “concerned about the impact on patients” that the changes might have, as well as there being “no mechanism in place to support community pharmacists” to help these patients.

The LPC was “disappointed” not to have received a formal response to its comments from September, she added.

Changes “haven’t been taken lightly”

When announcing the plans last week, East and North Hertfordshire CCG chair Dr Hari Pathmanathan said “these decisions haven’t been taken lightly”.

“Our conversations with the public have demonstrated that many people understand the challenges faced by the NHS in Hertfordshire and beyond,” he said.

“We understand that some of our patients will have to make changes, and they will be supported to do so,” he added.

East and North Hertfordshire CCG deputy chair Dr Nicky Williams said: “These policy decisions will not take away any GP’s ability to make decisions based on the individual welfare needs of their patients.”

NHS England's prescription agenda

In June, C+D hosted a roundtable debate with representatives from pharmacy, commissioning and Coeliac UK to discuss NHS England’s plans to scrap a range of products and services from prescriptions – including gluten-free foods.

You can listen to the full debate in the podcast below.

Has your CCG scrapped OTC products from prescriptions?

Gerry Diamond, Primary care pharmacist

I must admit that have restricted dearer OTC items and offer a cheaper generic alternative such as Peptac for Gaviscon, algeasl instead of diclofenac. But advise if they want dearer advertised brands then they can buy them. Get regular requests for ibuprofen and paracetamol which are acute meds and advise to get them from local chemists or super market.

Jonny Johal, Pharmacy Area manager/ Operations Manager

I am still unsure whether CCGs can legally deny treatment, however small, to people who are entitled to it free under the various NHS Acts.

The danger I see is the multiples will hike the prices of drugs like paracetamol to profiteer on the opportunity.

Gerry Diamond, Primary care pharmacist

Most independents have affordable prices and many patients go to Homebargains or B&M bargains and get paracetamol and ibuprofen for 16p. x

Dave Downham, Manager

Yep, they're the first port of call when I feel unwell.

mohamed nanji, Community pharmacist

its like telling turkey to vote for xmas and pharmacist are supporting this. CCG pharmacist are the ones who give these and branded generic ideas destroying community pharmacist earning when the CCG pharmacist are finally told good bye there will be no jobs left for them.

Frustrated Pharmacist, Community pharmacist

Well done the CCG. It saddens me that the LPC feel the need to chase this prescription revenue on behalf of their contractor members - we're all tax payers too you know!

Dave Downham, Manager

...actually, many of the people who need support are probably still owed their universal credit and are not taxpayers. While hertfordshire ain't the poorest area in the uk, there are a lot of people out there who cannot afford simple otc drugs. Maybe alliance or aah could make donations to food banks?

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