Pharmacy leaders have expressed grave concern that NHS England’s plans to stop certain products on prescription could exacerbate existing health inequalities, jeopardise patients’ wellbeing and lead to pressures on other parts of the NHS.
England Pharmacy Board chair Sandra Gidley welcomed proposals to scrap 18 treatments on prescription deemed low value including herbal remedies, homeopathy and dietary supplements as part of NHS England’s drive to save over £140 million a year.
Yet she warned that plans to stop over-the-counter treatments on prescription could endanger the health of people in vulnerable and deprived communities. NHS England will launch a consultation in the new year on an initial list of over-the-counter products that should no longer be prescribed such as paracetamol, cough mixture and cold treatments, eye drops, laxatives and sun cream lotions.
“We are pleased that NHS England have listened to the strong representation made by the Royal Pharmaceutical Society and others to take a patient-centred view on a number of the medicines included in the consultation,” Gidley said.
“We welcome the proposals to restrict prescribing of medicines where there are safer or more effective alternatives to ensure the NHS can continue to gain best value from the medicines it funds.
“A number of medicines were included in the consultation which if stopped or changed, could have a detrimental effect on the health outcome for some patients. NHS England has listened to our concerns and incorporated these in the final guidance for CCGs.
“However, the proposed new consultation on restricting prescribing of over-the-counter medicines for self-limiting conditions and self-care is of great concern.
“Community pharmacists are the right professionals to support patients to self-care and help to reduce pressure in other parts of the health service. Part of self-care may include buying OTC treatments when appropriate and affordable for an individual.
“However, we remain very concerned that the upcoming proposals on restricting prescribing of cost-effective and safe OTC medicines will end up exacerbating existing health inequalities and cause ill health amongst our most vulnerable and deprived communities, who cannot afford to pay for treatments.”
Gidley added: “Such a move would also violate principle 2 of the NHS Constitution which clearly states that ‘access to NHS services is based on clinical need, not an individual’s ability to pay’ and would fundamentally alter the relationship between patients and the NHS. We will respond to the consultation when it is published next year.”
Numark’s head of professional development Laura Reed warned there could be serious ramifications for patients if they cannot get hold of certain treatments on prescription.
“We all acknowledge that pharmacies can offer much greater support to the NHS and are ideally placed to support patients with self-care, however our members continue to struggle under the current financial pressures imposed and we must ensure they are fully valued and properly resourced if they are to deliver,” she said.
“As a profession, pharmacy must be involved in any discussions around restricting prescribing and directing patients to self-care from the start.
“Wider consideration also needs to be given to how the most vulnerable in society will be supported if they are no longer able to access items on prescription and if this may have unintentional consequences on other areas of the NHS such as out of hours and urgent care.
“Pharmacies will also be responsible for managing the expectations of patients referred by their GP to purchase treatment but where that treatment may be subject to the professional discretion of the pharmacist or even the product licencing. Both GPs and patients need to be aware of this professional responsibility and duty of care.”
Reed added: “Despite the pharmacy minister stating ‘things have moved on’ from minor ailments, this proposal once again raises the need for a national minor ailments scheme, something Numark have consistently called out for, as well as clearly demonstrating the valuable role pharmacy can play as an integral part of the NHS.”