Prescribing ban risks exposing GPs to complaints, warns GPC

NHS England proposals to ban prescribing of drugs available OTC could put GPs in breach of the GMS contract and leave them vulnerable to complaints, the GPC has warned.

Dr Andrew Green (Photo: JH Lancy)
Dr Andrew Green (Photo: JH Lancy)

NHS England opened a consultation this week on plans to crack down on GPs prescribing over 3,200 drugs that are also available OTC, in addition to 'limited value' treatments such as homeopathy.

But Dr Andrew Green, the GPC clinical and prescribing lead, told GPonline that the proposals would 'fundamentally alter' the relationship patients have with the NHS.

The plans could put GPs in breach of their GMS contract, with potential legal consequences if they refuse to prescribe treatments for drugs they have told patients are clinically necessary, he warned.

The contract states that prescribers should 'order any drugs, medicines or appliances which are needed for the treatment of any patient who is receiving treatment under the Contract'.

Any change to this procedure should be done through regulatory change by politicians, not through the channels NHS England is proposing, he added.

He further warned that the decision would add extra complexity to decisions about allowing new drugs to be sold OTC, because this would in future amount to barring these drugs from being given out via prescription.

GP complaints

He told GPonline: ‘Of course, we approve of patient self-care, and we would encourage them to use OTC methods for their own treatments whenever possible.

‘But these proposals are about denying patients treatments recommended by their GP – and that’s the main issue.

‘It will leave GPs open to complaints because what is proposed is against our regulations – we are required to issue an FP10 for treatments we have decided a patient needs.

‘Most of us will encourage people to buy the treatments themselves from the supermarket or pharmacist. But if a patient then asks for prescription we have a regulatory duty to supply that prescription.’

The change should be borne by politicians ‘who can bear the political fallout and carry responsibility for that decision’, he added.

‘But, instead of politicians standing up to do this, they are delegating it to GPs,’ he said. ‘It needs regulatory change, but no one is prepared to do that. They want to do it through guidance – but that will leave GPs open to complaint.

OTC drugs

‘The only people who should make that change is politicians, who should be accountable at the ballot box.’

Approving the proposals would add new depth to Medicines and Healthcare Products Regulatory Agency (MHRA)'s role of approving whether drugs should be made available OTC, he added.

A decision to approve a drug for sale OTC would also effectively bar it from being available through prescription – and that has never been considered as part of previous decisions.

An MHRA spokeswoman told GPonline: ‘We are committed to involving people in their healthcare, and to widening access to medicines for the benefit of public health when it is safe to do. We will work to support the initiative once the outcome of consultation is known.’

Outlining the OTC ban proposals last week NHS England chief executive Simon Stevens said: ‘The NHS is probably the world’s most efficient health service, but like every country there is still waste and inefficiency that we’re determined to root out.

‘The public rightly expects that the NHS will use every pound wisely, and today we’re taking practical action to free up funding to better spend on modern drugs and treatments.’

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