NHS England plans to ban the prescribing of over-the-counter and ‘low value’ medications in a radical cost-cutting measure.
NHS England has detailed plans, drawn up with family doctors and pharmacists, to cut out prescriptions for ineffective, over-priced and low-value treatments but the BMA say the move could hit the vulnerable the most.
The formal public consultation, which ended in October 2017, suggested introducing new national guidance banning the prescribing of 18 treatments and thousands of over-the-counter medications – which together cost taxpayers £141 million a year.
In the cost-cutting move, could see either a restriction or a complete ban on the prescribing of items that it deemed ‘low value’;
- Glucosamine and chondroitin.
- Herbal treatments.
- Lutein and antioxidants.
- Omega-3 fatty acid compounds.
- Paracetamol and tramadol Combination Product.
- Perindopril arginine.
- Once-daily tadalafil.
- Immediate-release fentanyl.
- Lidocaine plasters.
- Oxycodone and naloxone combination products.
- Rubefacients (excluding topical NSAIDs).
In addition, the consultation also covered a further 3,200 prescription items, many of which are readily available and sold ‘over the counter’ in pharmacies, supermarkets, petrol stations, corner shops and other retailers, often at a significantly lower price than the cost to the NHS.
But, the British Medical Associate, the Union for Doctors, say that if GPs refuse to prescribe the medication it could see them in breach of their contract. Inside the BMAs reply to the consultation, it said;
‘GPs can advise patients that treatments are available without prescription, but were a GP to refuse to issue an FP10 for treatment that they had recommended they would clearly be in breach of paragraph 14.2.2 and open to complaint and possible financial redress.
‘This would also place GPs in an invidious position with inevitable detrimental effects on GP/patient relationships. We would not support a change from the current wording unless alternative provision for NHS supply, such as through a minor ailment scheme, were provided.’
The reply goes on to say that a blanket ban on OTC prescribing would also ‘disadvantage vulnerable patients such as older age groups, patients with capacity problems including dementia and learning difficulties, people living in poverty or those needing help from carers’, as well as pregnant women, and widen health inequalities.
The results of the formal consultation have not yet been announced.
NMC apologises after misleading Morecambe Bay investigators
Up to 19 babies and mothers died between 2004 and 2012 as a result of mistakes by staff.
The regulator has apologised over how it handled a Fitness to Practice investigation.
The Nursing and Midwifery Council (NMC) has apologised over how it handled a Fitness to Practice (FtP) investigation following the tragic death of newborn Joshua Titcombe at Morecambe Bay.
The report was initially commissioned by Jeremy Hunt, the then Secretary of State for Health and Social Care, after up to 19 babies and mothers died at the hospital between 2004 and 2012 as a result of mistakes by the staff of its maternity unit.
Jackie Smith, the former Chief Executive and Registrar of the NMC, resigned on the eve of the PSA report.
‘Incorrect and misleading statements’.
Investigators highlighted concerns over a chronology that was submitted as evidence by Joshua’s parents. They commented that they regulator failed to include the chronology in the evidence gathering process and also failed to “consider and understand the significance of this evidence and its relevance to a central issue in the case.”
The NMC then went on to make “incorrect and misleading statements” to Joshua’s parents, the PSA and the Secretary of State for Health about how it handled and reviewed the chronology.
Verita also commented that the regulator failed to treated witnesses “with the respect and sensitivity they deserved”.
Investigator on to recommend that the “NMC should make it a priority to ensure that it treats families and patients with respect and is honest and open with them” and “ensure that Panel Chairs are fully briefed about the importance of showing respect to bereaved relatives, perhaps by using this example as a case study.”
The total cost of Verita’s report was £151,742.22.
‘I am very sorry’.
Andrea Sutcliffe CBE, the current NMC Chief Executive and Registrar, said: “Throughout these fitness to practise cases the way we treated Mr Titcombe and his family was unacceptable. Our actions made an awful situation much worse and I am very sorry for that. I am also very sorry that our communications with Mr Titcombe, the PSA and the Secretary of State for Health and Social Care contained incorrect and misleading information about our handling of this evidence.”
“This investigation highlights a number of failings at the NMC at that time. We did not properly understand the significance of this important piece of evidence, in particular to Mr Titcombe and his family, and we did not put it before the panel when we should have done. This reflected a culture at the NMC at that time that prioritised process over people.”
“Since the events at Morecambe Bay we have made significant changes, including much improved record keeping, the introduction of a new public support service, and additional training for panel members to help them better understand the needs of witnesses.
Hospital charity launches Christmas gift appeal for patients
Those wishing to help the campaign can buy a gift or donate online.
The Send a Smile with Santa campaign delivers presents to patients who are unable to celebrate Christmas at home.
A campaign to deliver more than 1,000 gifts for inpatients at the Norfolk and Norwich University Hospital on Christmas Day has begun.
The N&N Hospitals Charity’s Send a Smile with Santa campaign delivers presents donated by the public to patients, both young and old, who are unable to celebrate Christmas at home with their families.
Donations can also be dropped off by Sunday 8 December at the West Atrium Inpatient reception, Cromer Hospital, the Archant offices on Rouen Road, Norwich, and Greater Anglian Norwich Railway Station Customer Service.
The charity says that any donated presents should remain unwrapped so staff can ensure that presents are individually tailored for each patient, as well as protecting against potential infection.
‘Overwhelmed by kindness’.
Prof Nancy Fontaine, NNUH Chief Nurse, said: “We were overwhelmed by the kindness of people last year and we were able to deliver a lovely present to each of our patients.
“Nobody wants to spend time in hospital, and Christmas is so often a special time for people to be with family, and this is why we like to do something to make it a little nicer for our patients.
“We really hope that the people of Norfolk will once again support our appeal and help put a smile of the faces of our patients during the festive period.”
Louise Cook, Head of Fundraising at NNUH, added: “We know from our patients how lovely and unexpected it is to receive a gift on Christmas Day. They don’t need to be expensive gifts – toiletries, puzzle books, chocolates or socks are always greatly received.
“We have heard from people who would like to donate a gift but are unable to get out, so we this year we have an Amazon Wish List with small items which can be purchased and will be delivered directly to us, or a JustGiving page where a donation can be made and we will use that to purchase a gift for a patient.”
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