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Gluten-free restrictions represent a 'chipping away' of pharmacy

Dorset contractor Mike Hewitson: We'll start to see rationing of more pharmacy services
Dorset contractor Mike Hewitson: We'll start to see rationing of more pharmacy services

The blacklisting of various gluten-free prescription items “undermines principles” of the NHS and is “chipping away” at community pharmacy, according to pharmacists.

Pharmacy teams will not be able to dispense NHS prescriptions for any gluten-free items other than bread and mixes from December 4, the Pharmaceutical Services Negotiating Committee (PSNC) announced last month.

Pharmacists have expressed concerns that the move could unfairly impact patients on low or fixed incomes, and lead to a “postcode lottery” as to where gluten-free products will be available.

Mike Hewitson, owner of Beaminster Pharmacy in Dorset, said the move “undermines” the principle of providing a universal national health service which is free at the point of delivery.

The news also has the potential to damage patient relationships, as pharmacy teams will “get it in the neck” when having to explain NHS England’s “complicated” guidance on prescribing to patients, Mr Hewitson added.

“This represents the thin end of the wedge, and we’ll start to see more and more rationing of services,” he predicted.  

“What else can they take away from us?”

Raj Radia, owner of Spring Pharmacy in Hackney, said while the gluten-free prescription restrictions would only affect one of his patients on an “ad hoc basis”, he has concerns about further restrictions on what pharmacies can dispense.

Commissioners are “just chipping away” and “putting the nails in the coffin for community pharmacies” by slowly reducing what pharmacists can dispense, Mr Radia said.

“I’ve been working for over 31 years and I’m thinking ‘Oh my god, where are we going with this?’ I don’t think [the government and NHS England] see the bigger picture,” he added. “What else can they take away from us?”

A limited list is essential

Hitesh Patel, chief executive officer at City and Hackney local pharmaceutical committee, said storing and dispensing gluten-free items was often “tedious”, as some items had to be fresh and were difficult to source.

“I wasn’t a great fan of the whole range of gluten-free products available, but that’s my personal view. A limited list is obviously essential, especially if you have any socially vulnerable patients who can’t afford to get them from the supermarket,” he added.

Mr Patel said he does not think community pharmacies will suffer as a result of the restricted prescribing, as “a lot of gluten-free products are loss-leaders for pharmacies”.

“We’ll just have to wait and see what sort of backlash we get from the patients –­­ if any.”

Last year, C+D hosted a roundtable debate to discuss what plans to scrap certain treatments  including gluten-free items  from prescriptions would mean for pharmacists, patients, and the wider NHS. Listen to it below, and subscribe to all of C+D's podcasts here.

Has your CCG scrapped any other products on prescription recently?

Caroline Jones, Community pharmacist

The vunerable will suffer? When I hear comments like this I do wonder how those people with a gluten intolerance manage to survive in countries where there isn't a 'free' healthcare system? Presumably they use common sense and decide not to eat gluten containing food (there's plenty of healthy options!), or buy the GF free option in small, affordable quantities? On the plus side, cutting back on all these carbs might go some way to help the obesity crisis........

Caroline Jones, Community pharmacist

How much bread should people be eating anyway? I would imagine most people, not just those with a gluten intolerance, eat way too much - so it's a good opportunity for these patients to cut back. I'm sure most people could afford a loaf a week...

Richard MacLeavy, Dispenser Manager/ Dispensing Assistant

For a while its seemed at bit strange in most pharmacies, a healthy living zone in the corner proudly displays healthy living advice posters and highlights the danger of high sugar, high processed junk food, yet when you make it to the counter GF jaffa cakes, biscuits, and pizza bases are handed out courtesy of the NHS. 

Paul Dishman, Pharmaceutical Adviser

It's not 'chipping away at pharmacy', but a sensible rationalisation. Do get a grip.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Why should gluten-intolerant people get biscuits for free? I don't. It isn't a 'chipping away' at pharmacy at all. It's a fair response to what has been a very unfair system. When I began in pharmacy, GF stuff was fair game, even to the extent of cakes and puddings available gratis, courtesy of my taxes. I am not a supermarket.

Adam Hall, Community pharmacist

While I agree with the concerns about "chipping away at pharmacy" I have never been a fan of GF products on the NHS. Personally, I would love it if I got my grub for free from the NHS

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