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GPs may be stopped from prescribing homeopathic medicines

Plans to save the NHS £190m a year by restricting 18 treatments

Adrian O'Dowd

Monday, 24 July 2017

GPs could be prevented from prescribing homeopathic medicines and 17 other treatments deemed to be a waste of money or ineffective, under new plans.

NHS England published a consultation at the weekend which claims to be an effort to eradicate wasteful and ineffective drug prescriptions to save the NHS more than £190 million a year.

Under the plans, which were drawn up in consultation with GPs (NHS Clinical Commissioners) and pharmacists, NHS England is proposing that 18 treatments, including homeopathy and herbal treatments, should not be routinely prescribed in primary care.

These 18 treatments, which include herbal medicines, Omega-3 fatty acid compounds, rubefacients, travel vaccines including hepatitis B, yellow fever and rabies (sometimes mistakenly prescribed by GPs on the NHS), and paracetamol cost the NHS around £141 million a year.

In addition, the consultation also covers a further 3,200 prescription items, many of which are available and sold over the counter in pharmacies, supermarkets, and other retailers, often at a significantly lower price than the cost to the NHS.

The consultation for national guidance to CCGs proposes initial action to limit prescribing of products for minor self-limiting conditions which currently cost taxpayers £50m-100m a year. The products include cough mixture and cold treatments, eye drops, laxatives and sun cream lotions.

NHS England also wants to restrict the availability of gluten-free foods on prescription, which costs £26 million a year.

Simon Stevens, NHS England’s chief executive, said: “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.”

Sir Bruce Keogh, NHS England medical director, said: “At a time when we need to find all the money we can for new, highly effective drugs we must ensure every pound is spent wisely. An honest, plain English conversation is required about what we should fund and what we should not.”

Doctors’ leaders will respond formally to the consultation, but have already raised some concerns over the proposals.

Dr Andrew Green, BMA prescribing subcommittee chair, said: “The BMA’s GP committee recognises the need to prescribe in a cost-effective manner, but where prescribing is changed for any other reason than clinical benefit to the patient, the patient must be involved and the extra workload for GPs needs to be recognised.

“GPs have a contractual duty to prescribe drugs that their patients need, and pressure must not be placed on them to act in a way that may contravene those regulations.

“We encourage patients to self-care wherever possible, but the suggestion to restrict prescribing of effective drugs that are also available over-the-counter cannot be supported as it is likely to increase health inequalities and expose GPs to the potential for complaints.”

Professor Helen Stokes-Lampard, RCGP chair, said: “Prescription costs are a significant expense for the health service, and so if we can take safe, sensible measures to reduce these costs then we should.

“If patients are in a position that they can afford to buy over the counter medicines and products, then we would encourage them to do so rather than request a prescription – but imposing blanket policies on GPs, that don’t take into account demographic differences across the country, or that don’t allow for flexibility for a patient’s individual circumstances, risks alienating the most vulnerable in society.”

The consultation runs until 21 October.

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