North and Southern Derbyshire, Erewash, and Hardwick CCGs announced the adoption of a “self-care policy” last month, which will end the “routine…prescribing” of gluten-free products and “stop the prescribing of medicines and products available over-the-counter (OTC)…to treat short-term, minor self-limiting conditions”.

Three weeks later, the Department of Health and Social Care (DH) decided that gluten-free “bread and [flour] mixes only” should remain available on prescription across England, after considering scrapping gluten-free items entirely.

The following week, the four Derbyshire CCGs acknowledged the DH’s decision and “committed to review the impact of our local policy six months post-implementation”.

Consumer charity Healthwatch Derbyshire said last week (February 21) that it had found residents in the county “are particularly concerned about a disproportionate impact of the removal of gluten-free prescriptions for people on low incomes”.

“Concerns have also been expressed by those that live in rural areas, which may not have access to supermarkets that stock a range of gluten-free alternatives,” it said. “The smaller stores that people in rural areas may shop at often do not stock gluten-free foods.”

“It is vital to monitor the impact on patients” of the prescribing decision, the charity added.

LPC: GPs make the prescribing decisions

Derbyshire local pharmaceutical committee (LPC) chair John Sargeant told C+D: “We look forward to contributing to [the CCGs’] review and learning the outcome in due course.”

“Meanwhile, we recognise that it will be for GPs, ultimately, to make their own individual prescribing decisions.”

“We are confident that Derbyshire pharmacy contractors will continue to support patients and the public in providing dietary advice, signposting to appropriate agencies and sourcing gluten-free products whenever they are requested,” Mr Sargeant added.

In November 2017, Derbyshire LPC told C+D that “patients with coeliac disease should have access to gluten-free products”, and estimated there are 10,000 patients with the condition in the county.

CCG: “This will involve change for people”

The four CCGs said last week that there were “no immediate plans” to change their new gluten-free prescribing policy, and highlighted that the DH had admitted “it is for CCGs to decide” the commissioning of local services.

The CCGs – which made their gluten-free and OTC product prescribing decisions following two consultations in 2017 – stressed that their new self-care policy “would not affect the prescribing of items for longer-term or more complex conditions”.

Erewash CCG chair Dr Avi Bhatia said: “We do not take these important decisions lightly, and we know that the decisions will involve change for people who are currently receiving prescriptions for these products.”