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CCGs scrap gluten-free foods on prescription

The CCGs predict £283,000 can be saved per year by ending gluten-free prescriptions

Two clinical commissioning groups (CCGs) in West Yorkshire will scrap prescriptions for "a range of products", including gluten-free foods.

Greater Huddersfield and North Kirklees CCGs will stop the routine prescribing of gluten-free foods in 2017, which they estimate could save them around £283,000 a year.

Gluten-free foods are now “widely available” in local pharmacies and supermarkets, where they are cheaper for the public to buy than for the NHS to supply them, the CCGs claimed in a joint statement last week (January 11). 

The decision came after “careful consideration” and a public consultation, which received over 700 responses, the CCGs said. They stressed they would continue to work with community pharmacists to “communicate the changes to patients” and “support those who may be affected”.

Using the budget differently

Alongside gluten-free prescriptions, the CCGs have also scrapped prescriptions for other products (see box below), including sunscreens, emollients for minor skin conditions, and infant formula for lactose intolerance. The CCGs estimate this could save them £1.1 million per year.

GP and chair of NHS North Kirklees' governing body, David Kelly, said the CCG had to look at using its budget “in a different way”.

“Decisions like this are difficult and we know that some people will find them hard to accept, but the money can be spent on things that have more impact on people’s heath,” Dr Kelly said.

Branded medicines

The CCGs have also decided that requests by patients for “more expensive brands of medicines” will no longer be supported where a generic alternative is available.

They highlighted that unnecessary prescribing of branded medicines can cost the NHS “up to 56 times more than the equivalent generic products” and estimates around £400,000 could be saved in their area by ceasing these prescriptions.

It gave the example of atorvastatin, which can be prescribed in place of Lipitor, and omeprazole, which can be prescribed in place of Losec.

Products scrapped by the West Yorkshire CCGs:
  • Gluten-free foods
  • Sunscreens for skin protection from UV radiation 
  • Soya and thickened infant formulas
  • Infant formula for lactose intolerance
  • Cream for unwanted facial hair
  • Emollients for minor skin conditions
  • Multivitamins, where no specific deficiency has been indentified.
Do you agree with the CCG's decision?

David Moore, Locum pharmacist

Kernow (Cornwall) CCG dropped GF lines last year. No sign so far that the World is coming to an end.

Brian Austen, Senior Management

You may or may not consider this related. Why should a patient receiving diabetes medication get their asthma prescription and all other medication for free but the patient that only needs asthma medication has to pay for it, if they are not exempt of course.

Lucky Ex-Locum, Superintendent Pharmacist

Good point. i've always thought that the medical exemption should only apply to drugs to directly treat the exempt condition. It also seems very unfair that thyroid patients (not particularly life threatening) don't pay for anything while asthma patients (most definitely life threatening) have to pay for everything and generally multiple items at that.

Paul Samuels, Community pharmacist

Sensible decision--well overdue--in many cases,particularly GF,. blatant oversupply.

Similarly patients asking for original brands where generic products no different particularly irritating!!

Shaun Steren, Pharmaceutical Adviser

These sort of decisions in healthcare run parallel to decisions being made in other state departments. There is a realisation amongst the British people that we have been living well beyond our means. In a peculiar way it is becoming a unifying feature within the country. 

Most British people are economically progressive, it is considered fair play that those who earn more should pay significantly more into the system. Most British people even accept that the NHS is underfunded and only the honest solution is for everybody to make greater contributions through taxation. 

What people are no longer willing to tolerate is abuse of the system. More importantly, people are beginning to realise how the business sector is profiting from this abuse, cloaking such profiteering under the guise of helping the 'disadvantaged' and 'vulnerable'. It is a scam, one in which community pharmacy is complicit. 

Jupo Patel, Production & Technical

Some would argue complicit is rather an understatement.

Shaun Steren, Pharmaceutical Adviser

I don't know that contractors have ever encouraged the supply of GF products in any way. To what end? A couple of extra prescription fees per year? 

Now if there was a Gluten Free Service (GFS) involving fees for 'helping patients understand and better use their pasta', then that would be different. We would have an avalanche of outrage at this decision, with witless claims of coeliacs dying on the streets. 


Stephen Eggleston, Community pharmacist

The only one I would question is stopping milk for lactose intolerance infants. Other than that, couldn't agree more

geoffrey gardener, Community pharmacist

Many people have to buy formula for their babies, surely the fairest way would be to allow parents of lactose intolerant infants to buy their milk at the going rate for "normal" milk

Yo Palumeri, Community pharmacist

middle class decision makers with high disposable income really care don't they

Shaun Steren, Pharmaceutical Adviser

Being middle-class and having a high disposable income is indicative of callousness? Is this on a scale of evil? Would a QC barrister be particularly wicked, with a university lecturer being slightly less malevolent? Is this a food specific spitefulness or are the wealthy middle-class innately villainous? 

I wondered how long it would be before the first virtue signaller would arrive. Congratulations, you got here early. 

Raluca Chisu, Community pharmacist

To remove Gluten-free foods, was good - a lot of lactose intolerant people are buying the food, diabetes too, etc - so good point.

Sunscreens for skin protection from UV radiation  - same as above

Soya and thickened infant formulas & Infant formula for lactose intolerance - here I have my concern, after all an infant is an infant and should be protected and if is a lactose intolerant, we have to support this.

Cream for unwanted facial hair - no objection

Emollients for minor skin conditions - no objection

Multivitamins, where no specific deficiency has been indentified - no objection

Shaun Steren, Pharmaceutical Adviser

Bravo! Remove every single GF item from the Drug Tariff and make it national. 

C Fulcher, Superintendent Pharmacist

Definitely an overdue move

Lucky Ex-Locum, Superintendent Pharmacist

Not so sure about the infant formula but definitely for the GF stuff. I have to buy my bread.

Once did a prescription for one box of GF cornflakes which was classed as a special. It cost the NHS £70 when you could get them in Tescos for about three quid.

Bob Dunkley, Locum pharmacist

Perhaps this is the opportunity to remove other items from NHS prescribing- paracetamol springs immediately to mind.

Tracy Smith, Dispenser Manager/ Dispensing Assistant

Absolutely about time!

Valentine Trodd, Community pharmacist

Finally, some common sense! Roll out nationally.

JOHN MUNDAY, Locum pharmacist

For many years, I have had misgivings about the supply of gf foods on FP10s. All of us have seen the mounds of biscuits, pasta, bread mix etc etc. being supplied week after week. Having tasted this 'food', I really wonder how folks can eat in the first place. I can also see where this is regarded as a waste of valuable NHS resources. We have an opportunity here. Most supermarkets supply this food as a matter of course these days with a modest premium. For non-coeliacs, if you want decent bread, you pay a premium price. Pharmacy can exploit this. If we have GF patients, why not work something out where they can order the products online with your Pharmacy, and you supply. You could offer loyalty discounts together with free samples of new lines. I am thinking aloud here but the principal that we supply gf bread and vitamins harks back to WW2 and does not reflect 2017's financial woes.

Brian Smith, Pharmacy technician

Completely agree. Overdue mind you. Now lets see every CCG follow suit. Get rid of these money wasting items now.

Z ZZzzzz, Information Technology

Good.  I would go further to say that this should not be left to each CCG to do this area by area, it should happen nationally at the same time!

Diana Taylor, Primary care pharmacist

It used to be called the blacklist and it's still in the drug tariff, it just doesn't seem to get updated any more. It definitely should be a national scheme, but the W York's CCGs are right to do it

Z ZZzzzz, Information Technology

When Labour were the govt, they abolished the QUANGO that used to meet every six months to determine adding to or deleting from the blacklist.  That is why so many manufacturers have gotten away with getting around the blacklist by renaming certain products - Calpol being the classic example.

I agree the GF products should be added to the blacklist, but that can't happen unless the present government sets up the blacklist committee again.

JOHN MUNDAY, Locum pharmacist

Agreed - I noticed that Solpadeine Plus tablets are not in the blacklisted list in the DT like all the other Solpadeine lines- so, what did I dispense 112 of yesterday? No prizes for the right answer sadly!

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