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a wheat field imageFebruary 5 2018

Gluten-sensitive enteropathy patients may still have certain gluten-free products prescribed on the NHS, but from a restricted range and subject to clinical commissioning group assessment.

The Department of Health and Social Care has published its recommendation following a consultation on the availability of gluten-free foods on NHS prescription in primary care. In it, the DHSC said that products that can be prescribed should be restricted to bread and mixes only.

Under the consultation, designed to reduce the primary care prescription drugs bill by up to £22.4 million per annum, three options were proposed:

  • to make no changes to the current regulations;
  • to remove gluten-free food prescribing entirely;
  • to only allow the prescribing of certain GF foods (eg bread and flour) in primary care.

“The health minister’s preferred option is option 3 – to restrict prescribing to certain GF products. This is likely to result in retaining a smaller range of bread and mixes, as the preferred product types following the consultation,” said the DHSC’s report.

The change to prescribing will require an amendment to Schedule 1 of the NHS (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004.

The charity Coeliac UK welcomed the decision to retain access to gluten free breads and flour mixes on prescription in England. “We believe the government made a reasonable decision at a time when the NHS in England is facing significant financial challenges,” it said.

“The work undertaken by the DHSC has recognised the need for patients with coeliac disease to have ongoing support to manage their condition, and they have paid attention to the evidence we have put forward about the cost, availability and nutritional contribution of gluten free staples in managing a gluten free diet.”

However, it added: “While we are pleased that the needs of coeliac disease patients are being recognised at a national level, we are very concerned at the actions already taken by individual CCGs to remove access to gluten free food on prescription in some regions. We will be working hard to make sure individual CCGs fulfil their obligations to manage the health of their patients with coeliac disease, particularly those most at risk of being unable to maintain a gluten free diet.”

NHS Clinical Commissioners was less supportive of the DHSC decision. Its Chief Executive, Julie Wood, said: “In a time when NHS resources are stretched to their limit, we believe that this is a missed opportunity to release the whole of the £22m that is currently spent on gluten free products that could be spent on frontline NHS services.

“While our members would have preferred the Department to go have gone further and removed the availability of all gluten free products on prescription, we welcome the decision that does limit a significant proportion of the current spend. We were also pleased to see the clarification that it does not affect the statutory authority that a CCG has to determine the availability of gluten-free foods in their local area – and to potentially go further if that is what is supported locally.”

She said that with pressures on NHS finances and services, “we must all be bolder in making decisions that mean money currently being spent on foodstuffs is spent on other priority areas such as mental health and primary care, where local clinicians, patients and members of the public feel it is appropriate and safe to do.”

Links:
DHSC announcement   
NHSCC statement        
Coeliac UK statement  

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