NHS England consults on plans to restrict prescribing of OTC products

NHS England has launched a consultation on plans to restrict GP prescribing of some OTC products in a move that it says could free up as much as £136m of NHS funding.

The consultation is looking at prescriptions for products that are available OTC for minor ailments and short-term self-limiting illnesses. NHS England said the proposals would not affect prescribing of items for longer term or more complex conditions, or minor illnesses that are symptomatic or a side effect of something more serious.

Eight self-limiting conditions and 25 minor ailments, which NHS England says are suitable for self-care, are covered by the consultation – see below for the full list. The consultation will also look at whether probiotics and vitamins and minerals should be prescribed in primary care.

GPs have previously warned that banning prescribing of drugs available OTC could put GPs in breach of the GMS contract and leave them vulnerable to complaints. However, a poll carried out by GPonline earlier this year found that most GPs are in favour of the ban coming into effect.

Analysis by GPonline earlier this year found that 17.8m items in categories likely to be heavily affected by restrictions on prescribing drugs available OTC were prescribed by GPs over the three months from April to June this year.

The consultation forms part of the wider Medicines Value Programme which ‘aims to ensure greater value from the NHS’ £17.4bn medicines bill, through improving health outcomes; reducing waste, over-prescribing and over-treatment; and addressing excessive price inflation by drug companies.’

As part of this programme NHS England last month issued guidance to CCGs on 18 ‘low value treatments’, including fish oil, herbal remedies and homeopathy, that should no longer be prescribed in primary care.

RCGP chair Professor Helen Stokes-Lampard said: 'Where patients can afford to buy medication over the counter, we would certainly encourage them to do so. There are also many minor, self-limiting conditions for which patients don’t often need to seek medical assistance, or prescribed medication, and can dealt with through self-care.

'What remains imperative – and we will be making this clear in our consultation response – is that no blanket bans are imposed, and GPs will retain the right to make clinical decisions about prescribing appropriately for our patients based on the unique physical, psychological and social factors potentially impacting on their health.'

Conditions covered by the consultation
  • Acute sore throat
  • Cold sores
  • Conjunctivitis
  • Coughs, colds and nasal congestion
  • Cradle cap (seborrhoeic dermatitis – infants)
  • Haemorrhoids
  • Infant colic
  • Mild cystitis
  • Contact dermatitis
  • Dandruff
  • Diarrhoea in adults
  • Dry eyes/sore tired eyes
  • Earwax
  • Excessive sweating (hyperhidrosis)
  • Head lice
  • Indigestion and heartburn
  • Infrequent constipation
  • Infrequent migraine
  • Insect bites and stings
  • Mild acne
  • Mild dry skin/sunburn
  • Mild to moderate hayfever/seasonal rhinitis
  • Minor burns and scalds
  • Minor conditions associated with pain, discomfort and fever
  • Mouth ulcers
  • Nappy rash
  • Oral thrush
  • Prevention of dental caries
  • Ringworm/athlete's foot
  • Teething/mild toothache
  • Threadworms
  • Travel sickness
  • Warts and verrucae

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