NHS England to curb prescription costs
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- Published: Thursday, 04 January 2018 07:49
- Written by News Editor
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NHS England has launched a consultation to rein in prescriptions and buy ‘over the counter’ products, such as dandruff shampoo and drops for tired eyes, freeing-up up to £136 million to expand other treatments for major conditions. Some dental conditions are included, which could prove controversial.
Ending routine prescribing for minor, short-term conditions, many of which will cure themselves or cause no long-term effect on health, would free up NHS funds for frontline care, they say. The consultation does not affect prescribing of items for longer term or more complex conditions or where minor illnesses are symptomatic or a side effect of something more serious.
Over-the-counter products currently prescribed include remedies for dandruff, indigestion, mouth ulcers and travel sickness. The NHS each year spends:
- £4.5 million on dandruff shampoos – enough to fund a further 4,700 cataract operations or 1,200 hip replacements every year.
- £7.5 million on indigestion and heartburn – enough to fund nearly 300 community nurses.
- £5.5 million on mouth ulcers – enough to fund around 1,500 hip replacements.
If patients were to self-care for these three conditions alone, it would save the NHS £17.5 million allowing funds to be diverted to other areas.
NHS England chief executive Simon Stevens, said: “To do the best for our patients and for taxpayers it’s vital the NHS uses its funding well. This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing-up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”
The over the counter medicines proposals for consultation include stopping the routine prescribing of products that:
- Have low clinical value and where there is a lack of robust evidence for clinical effectiveness, such as probiotics, vitamins and minerals.
- Treat a condition that is considered to be self-limiting, so does not need treatment as it will heal/be cured of its own accord, such as sore throat or coughs and colds.
- Treat a condition which could be managed by self-care, i.e. that the person does not need to seek medical care or could visit a pharmacist, such as indigestion, mouth ulcers and pain relief.
The consultation and guidance document is available here: www.engage.england.nhs.uk/consultation/over-the-counter-items-not-routinely-prescribed/
Dental conditions where GPs’ prescribing may be curtailed.
Mouth ulcers
‘A condition that is a minor illness and is suitable for self-care and treatment with items that can easily be purchased over the counter from a pharmacy.
Annual Spend £5,500,000
Rationale for recommendation
Mouth ulcers are usually harmless and do not need to be treated because most clear up by themselves within a week or two. Mouth ulcers are common and can usually be managed at home, without seeing your dentist or GP. However, OTC treatment can help to reduce swelling and ease any discomfort.
Recommendation
Advise CCGs to support prescribers in advising patients that a prescription for treatment of mouth ulcers will not routinely be offered in primary care as the condition is appropriate for self-care.
Prevention of dental caries
‘A condition that is a minor illness and is suitable for self-care and treatment with items that can easily be purchased over the counter from a pharmacy.
Annual Spend: £100,000
Rationale for recommendation
The dentist may advise on using higher-strength fluoride toothpaste if you are particularly at risk of tooth decay. Higher fluoride toothpastes and mouthwashes can be purchased over the counter.
Recommendation
Advise CCGs to support prescribers in advising patients that a prescription forhigh fluoride OTC toothpaste should not routinely be offered in primary care as the condition is appropriate for self-care
Teething/Mild toothache
A condition that is a minor illness and is suitable for self-care and treatment with items that can easily be purchased over the counter from a pharmacy.
Annual Spend: £5,500,000
Rationale for recommendation
Teething can be distressing for some babies, but there are ways to make it easier for them. Teething gels often contain a mild local anaesthetic, which helps to numb any pain or discomfort caused by teething and these can be purchased from a pharmacy. If baby is in pain or has a mild raised temperature (less than 38C) then paracetamol or ibuprofen suspension can be given.
Toothache can come and go or be constant. Eating or drinking can make the pain worse, particularly if the food or drink is hot or cold. Mild toothache in adults can also be treated with over the counter painkillers.
Recommendation
Advise CCGs to support prescribers in advising patients that a prescription for teething in babies or toothache in children and adults will not routinely be offered in primary care as the condition is appropriate for self-care.
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