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NHS England plans to cut indigestion prescriptions

21 December 2017

NHS England plans to cut indigestion prescriptions

NHS England is proposing to cut free prescriptions for over-the-counter remedies such as dandruff shampoo, eye drops and indigestion tablets in an effort to make up a shortfall in its funding.

The plans, which have alarmed the Patients Association, will explore restricting prescriptions for a number of mild ailments.

Promoting the idea, NHS England revealed that it currently spends £4.5m a year on dandruff shampoos – a sum that would fund 1,200 hip replacements. It said 300 community nurses could be funded from the £7.5m spent on treatments for indigestion and heartburn.

Other readily available items such as cough mixtures, laxatives and sun creams would also be reined in, it said.

NHS England said the changes could cut costs by £136m and make money available to help with the treatment of more serious conditions.

Its chief executive, Simon Stevens, said: “This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”

The Patients Association said the plans would unnecessarily worry many vulnerable people in the run-up to Christmas. Its chief executive, Rachel Power, said the proposals threatened to change the relationship between GPs and patients.

“GPs will be asked to implement guidance involving a complex set of criteria and exceptions,” she said. “Mistakes are bound to happen, and for some patients a GP appointment will come to feel more like a benefits assessment, where they wait to find out at the end whether they will receive support or not – and sadly we know there are major shortcomings with that system.”

She agreed that it was “counterintuitive for the NHS to be paying pounds for something that the individual can buy for pence”, but she called for clarity from NHS England on how the proposal would affect those deemed social vulnerable.

NHS England approved the proposals after the chancellor, Philip Hammond, announced £1.6bn in extra funding for 2018-19 in the budget last month – less than half of the £4bn that Stevens had called for.

Power said the prescription proposal “may or may not be a good idea, but it certainly shouldn’t be motivated by a funding crisis”.

Under the plans, prescriptions could be restricted for treatments for cold sores, conjunctivitis, mild indigestion, dandruff, haemorrhoids, infant colic, minor burns and scalds and minor pain conditions such as headache and back pain.

Remedies for mouth ulcers, nappy rash, ringworm, head lice, mild toothache, travel sickness, and warts and verrucae are also among the items that could also be affected, as well as vitamins and minerals.

Items prescribed for longer-term or more complex conditions would not be affected, and nor would prescriptions for minor illnesses symptomatic of something more serious, NHS England said.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said: “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.”

The consultation comes just weeks after the health service’s board voted to cut a number of items from the NHS prescription list in England.

Officials agreed 13 items deemed “ineffective, over-priced and low value treatments” – including homeopathy, herbal remedies and some painkillers – should no longer be routinely prescribed.

They said an additional five items should only be provided in appropriate circumstances.


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