The Department of Health and Social Care (DH) decided last week that gluten-free “bread and [flour] mixes only” should remain available on prescription across England, following a public consultation that received almost 8,000 responses.

But NHS Clinical Commissioners (NHSCC) – the independent organisation representing CCGs in England – told C+D it is “pleased” that the DH's decision “does not affect the statutory authority that a CCG has”.

NHSCC chief executive Julie Wood said CCGs can still “go further” and remove gluten-free foods on prescriptions, “if that is what is supported locally”.

“While our members would have preferred the DH to have gone further, we welcome the decision that does limit a significant proportion of the current spend,” Ms Wood said.

The DH's gluten-free consultation – which ran from March 31-June 22, 2017 – gave respondents three options: make no changes; stop the prescribing of all gluten-free foods; or “only allow the prescribing of certain gluten-free foods (eg bread and flour)”. Seventy per cent of all respondents opting for gluten-free prescribing to be restricted.

According to the DH’s impact assessment, 25 CCGs no longer prescribe gluten-free foods, while 102 implement restrictions around “product type, quantities or patient status”.

"Missed opportunity"

Ms Woods described the outcome of the consultation as a “missed opportunity to release the whole of the £22 million that is currently spent on gluten-free products”.

“If the NHS is to deliver what is expected of it within its current financial allocation, then we must all be bolder in making decisions that mean money being spent on foodstuffs is spent on other priority areas, such as mental health and primary care.”

Ms Wood stressed that CCGs are forced to make difficult decisions on a “daily basis”, that “balance the needs of the individual against those of the entire local population”.

“There are some tough choices that have to be made and many of our members have already taken the decision to go further than the DH,” she added.

In June 2017, C+D hosted a debate – which brought together NHSCC co-chair Graham Jackson, Coeliac UK CEO Sarah Sleet and pharmacy representatives Sandra Gidley and Hitesh Patel – to discuss what plans to scrap certain products and treatments, including gluten-free foods, from prescriptions could mean for the sector. Listen to C+D's podcast of the debate below: