Bath and North East Somerset’s Clinical Commissioning Group (B&NES CCG) is making some changes to its local prescribing policy.
Like other NHS organisations across the country, it has been assessing the effectiveness, health benefits and value for money of some treatments. As a result, following public consultation, the CCG is advising local GPs to prescribe gluten-free products to only the most vulnerable people living with coeliac disease. It is also advising GPs not to prescribe two types of over-the-counter medicines, painkillers and antihistamines, when used for short-term, minor ailments.
Dr Ruth Grabham, Medical Director of the CCG and local GP said: “Demand for all local health and care services is rising, but we have a limited budget. This means we have to look very carefully at where we spend our money. Last year, the CCG spent nearly £500,000 on painkillers and antihistamines and £112,000 on gluten-free products. We believe this money should be used to commission other services which would be of greater benefit for more patients.”
The prescribing decisions were made following a four-week period public engagement from 24th November to 21st December last year. Historically, gluten-free foods were not widely available, and receiving them via prescription was often the only way that many patients could access them. However, today there is much more awareness of coeliac disease, gluten sensitivity and other similar conditions and gluten-free foods are much easier to buy, with an increasingly varied range of products available from supermarkets and online retailers.
The price paid by the NHS for gluten-free foods on prescription is much higher than the price of similar products found in supermarkets. Many respondents commented on the need to not impose a blanket policy and asked for key exemptions for certain groups. Some people raised concerns about the price of gluten-free products and the impact on older people, children and families on low incomes. As a result of this feedback, the CCG will be providing GPs with guidance to identify and support vulnerable people, such as those on low incomes, children and people with learning difficulties. GPs will continue prescribing gluten-free where they are sufficiently convinced that a patient’s long-term health may be adversely impacted.
Paracetamol and other painkillers cost around 1p per tablet in supermarkets and community pharmacies compared to 3p per tablet through the NHS. In addition, a significant proportion of GP surgery time is taken up processing prescriptions for minor ailments which could be managed by patients or their carers without the need for prescription medicines. In certain exceptional cases GPs may deem it medically necessary to prescribe these treatments. The policy changes will be phased in from April 2017.