PCT cuts threaten coeliac care

GPs should resist pressure from PCTs to cut costs by denying coeliac patients gluten-free foods on prescription, GP experts have advised.

The high cost of gluten-free foods and patient immobility mean that patients often fail to adhere to a strict gluten-free diet, leaving them at risk of complications such as osteoporosis.

The Primary Care Society for Gastroenterology (PCSG) has recommended that GPs should prescribe a minimum one-month supply of gluten-free staples such as bread and pasta to coeliac patients.

Dr Richard Stevens, chairman of the PCSG, said PCT cutbacks were limiting GPs' ability to manage patients with coeliac disease properly.

'Some prescription advisers are patchy on giving funding for prescribing gluten-free foods,' he said.

Eastbourne Downs PCT and North Lincolnshire PCT have both introduced restrictions on entitlement to gluten-free food on prescription.

David Fullard, director of corporate affairs at North Lincolnshire PCT, said: 'Belt-tightening measures are necessary and this unfortunately is one of them.'

He said that GPs could still prescribe items of a 'specialist nature', but were not allowed to prescribe purely gluten-free products that were 'a food item'.

Dr John Clarke, medical director of Eastbourne Downs PCT, said that the trust had chosen to limit gluten-free prescribing after a 30-fold increase in two years.

Dr Jim Kennedy, RCGP prescribing spokesman, said that under the GMS contract, doctors must provide gluten-free food to people with coeliac disease.

'Not to provide such medication or intervention might put us in breach of our terms,' he said.

Around one person in 100 has coeliac disease, but the PCSG fears four case in five are missed, or misdiagnosed as IBS.

Diarrhoea and weight loss are the main signs of coeliac disease.


PCSG; Live links at GPonline.com

- 600,000 in UK have coeliac disease.
- Just one in five has been diagnosed.
- 44 per cent wait a year after first presenting with symptoms.
- Patients should be prescribed a month's supply of gluten-free food.

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