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  • Details of flu vaccine ordering for 2018-19 season published

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    Thursday, 08 February 2018 10:52
  • 'Easy access' initiatives could fragment GP services, warns Nuffield report

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    Wednesday, 07 February 2018 14:29
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    Monday, 05 February 2018 11:56
  • NHS England prepares to launch ACO consultation

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    Wednesday, 31 January 2018 10:40
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    Friday, 26 January 2018 19:31

a doctor in consultation imageDecember 1 2017

The first group of products that which should no longer be ordinarily prescribed on the NHS in England has been approved by the NHS England Board.

A consultation over the summer proposed limiting the prescribing of treatments of low value or effectiveness, and/or which can be purchased over the counter. Following its Board meeting on November 30, NHS England is now advising clinical commissioning groups and GPs that the following should no longer be routinely prescribed:

  • homeopathy – “no clear or robust evidence to support its use”;
  • herbal treatments – “no clear or robust evidence to support its use”;
  • omega-3 fatty acid compounds – “essential fatty acids which can be obtained through diet, low clinical effectiveness;
  • co-proxamol – it has had its marketing authorisation withdrawn due to safety concerns, no new pateints should be started on co-proxamol, and and it should be ‘deprescribed’ for existing patients;
  • rubefacients (excluding topical NSAIDS) – “limited evidence”;
  • lutein and antioxidants – used to treat the eye condition age related macular degeneration, “low clinical effectiveness”;
  • glucosamine and chondroitin – “low clinical effectiveness”.

NHS England will also commence a new detailed consultation in 2018 on which self-limiting conditions should be included in the programme to limit prescribing of OTC products. This could mean restrictions on prescribing paracetamol, cough mixture and cold treatments, eye drops, laxatives and sun cream lotions.

“The NHS could save around £190 million a year by cutting such prescriptions for minor, short-term conditions, many of which will cure themselves or cause no long-term effect on health,” said NHS England.

Dr Graham Jackson, NHSCC co-chair and clinical chair of NHS Aylesbury Vale CCG, said: “The guidance launched today, which resulted from work we initiated on behalf of our members, will support clinical commissioners in their work to prioritise effectively and make sure they are getting the best value for their medicines spend.

“We were pleased by the volume of responses to the consultation, which gave an opportunity to take into account and reflect the views of public, patients and clinicians and key stakeholders in the final guidance. We need to carry on having these honest open conversations on what the NHS can and should provide with the funding it has, so that we can continue to deliver high quality care.”

National Voices, the coalition of 160 health and care charities, has raised concerns regarding the proposed restrictions on prescribing OTC medicines. “This would include treatments dispensed to the millions of people who qualify for free prescriptions, such as those on Jobseeker’s Allowance or Employment and Support Allowance, older people, children, pregnant mothers, and people living with cancer,” it said.

Don Redding, Director of Policy at National Voices, added: “If taken forward, these plans could mean that some treatments are only available to those who can afford them. This would risk adversely affecting those people who currently get free prescriptions, which includes some of the most vulnerable in our society and those who are ‘just about managing’.

“Yes, there are difficult decisions for the NHS to make, but the rationing of treatments should not be targeted at those most in need, and those already living on a financial knife-edge.”

He said the organisation had “noted NHS England’s commitment to meaningfully engage patient groups to understand these unintended consequences and we look forward to working with them.”

Links:
NHS England announcement      
NHS England Board Paper setting out the proposals for the initial list and summarising consultation responses    
NHS England - Items which should not be routinely prescribed in primary care      
National Voices comment             

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