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NHS plans to ban the prescribing of over-the-counter and 'low value' medications

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by Sarah J.
NHS plans to ban the prescribing of over-the-counter and 'low value' medications

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.

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In the cost-cutting move, could see either a restriction or a complete ban on the prescribing of items that it deemed 'low value';

Blacklisted;

  • Co-proxamol.
  • Dosulepin.
  • Glucosamine and chondroitin.
  • Herbal treatments.
  • Homeopathy.
  • Lutein and antioxidants.
  • Omega-3 fatty acid compounds.
  • Paracetamol and tramadol Combination Product.
  • Perindopril arginine.
  • Once-daily tadalafil.
  • Trimipramine.

Restricted;

  • Immediate-release fentanyl.
  • Lidocaine plasters.
  • Oxycodone and naloxone combination products.
  • Rubefacients (excluding topical NSAIDs).
  • Liothyronine.

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.

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‘Red bags’ will get patients home from hospital quicker

Innovative ‘red bags’ will help community patients admitted to hospital be discharged quicker are being rolled out across the country.

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by Matt Bodell.
‘Red bags’ will get patients home from hospital quicker

The ‘Hospital Transfer Pathway’ or ‘Red Bag’ helps provide a prompt, safe and efficient transfer of care.

Innovative ‘red bags’ will help community patients admitted to hospital be discharged quicker are being rolled out across the country.

Red bags will contain contains a copy of their personal information, past medical history, a supply of medicines and a change of clothes for when they are ready to be discharged.

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The simple initiative started three years ago in Sutton, South West London, and now all areas of the country are being urged to adopt the scheme with a toolkit launched today to help.

As well as giving reassurance to patients, the red bags will provide hospital staff with quick, up-to-date information and medication requirements for the patient, avoiding unnecessary phone calls.

The personal touch makes a big difference.

Professor Stephen Powis, NHS England National Medical Director, said: “This is an example of where a joined up approach is helping to improve patient care and speed up a stay in hospital for all the right reasons. Sometimes it’s the personal touch that makes a big difference to patients, especially if they’re elderly, and the red bag helps people feel reassured and more at home. Doing more of the obvious is key to improving all our experiences of care.”

Caroline Dinenage, Minister for Care at the Department of Health and Social Care, said: “This scheme is an excellent example of the NHS and social care system working together to improve care and support for vulnerable older patients. Not only is this more efficient – saving valuable resources – but it’s a much better experience for patients leaving hospital when their treatment has finished.

“It’s encouraging to see this scheme being rolled out across the country as we move towards our ambition of joined up care that is centred around the individual.”

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Government review could lead to the legalisation of medical marijuana

Many argue that painkillers such as morphine are legal despite being an opiate like heroin, so medicalised cannabis should be treated no differently.

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by Chloe Dawson.
Nurses call for the decriminalisation of cannabis for medical use

The government announced it will review its ban on the medical use of marijuana.

Sajid Javid, the Home Secretary, announced the review in the House of Commons yesterday, saying there is "a pressing need to allow those who might benefit from cannabis-based medicines to access them", adding “If the review identifies that there are significant medical benefits, then we do intend to reschedule”.

Over 40 countries, including Italy, Finland, Australia, Canada, Switzerland, Germany and half of the United States, have decriminalised cannabis in some form and many studies have suggested that cannabis can be useful in the treatment of chronic pain and the management of conditions such as epilepsy.

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In the coming months, Chief Medical Officer, Sally Davies, will review the evidence for cannabis-based medicine and provide a set of recommendations for the Advisory Council on the Misuse of Drugs Act.

It should be treated in the same way as Morphine.

Many argue that painkillers such as morphine are legal despite being an opiate like heroin, so medicalised cannabis should be treated no differently.

Currently, cannabis is a class-b drug subject to strict restrictions, it cannot be prescribed, administered or supplied to the public, and can only be used for research under a Home Office licence. One exception to this rule is Sativex, which has been available for use as a medicine without the need for a Home Office licence since 2013.

In May, Royal College of Nursing members voted overwhelmingly in favour of calling for the Government to decriminalise the use of cannabis for medical conditions.

Janet Davies, RCN Chief Executive and General Secretary, has previously said on the issue: “The sorts of conditions we heard about today, the terrible pain that people can be in, if people feel there’s something that will relieve that pain it’s worth a try.”

The government has said "absolutely no plans" to decriminalise the drug for recreational use.

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Unions call for pay deal to be extended to the private sector

Thousands of NHS workers, many of whom are the lowest paid, have been excluded from the deal because they are indirectly employed by the NHS.

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by Ian Snug.
Unions call for pay deal to be extended to the private sector

Healthcare unions have warned that a “dangerous imbalance” between sectors could cause harm to patients.

The Royal College of Nursing and Unite have called on the government to ensure the NHS pay deal is extended to those providing NHS services in social care, the private sector and primary care.

The NHS pay deal, formally accepted by healthcare unions earlier this month, will mean at least a 6.5% increase for the majority of NHS staff in England. Pay negotiations in Scotland, Wales and Northern Ireland are ongoing.

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However, thousands of NHS workers employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers, have been excluded from the deal because they are indirectly employed by the NHS but still have a direct impact on patient care.

Made to feel like the poor relations.

Colenzo Jarrett-Thorpe, Unite National Officer, said: “Excluding indirectly employed NHS workers from the new pay deal is unjust. It will be a disaster for morale with thousands of low paid NHS workers being made to feel like the poor relations of NHS employees. 

"Regardless of whether an NHS worker is employed by a private company or the NHS, they are still health workers and their contribution to patient’s health must be recognised.”

In a letter to Jeremy Hunt, Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: "“I urge you to consider how to address the pay of all nurses and health care assistants providing NHS services, whoever their employer, so that a gap in pay does not result in workers being drawn away from primary, community and social care services.

”This would include those employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers.

"I do believe that without this additional funding, we will see a dangerous imbalance of the workforce, which will significantly harm patients of non-NHS services.

"Many of our members delivering NHS services but not employed by NHS organisations complain that they endure poorer working conditions, loss of career and education opportunities,"

"We recommend the establishment of a new and separate national staff council, negotiating for all nurses and care assistants in health and social care who are not directly employed by an NHS organisation."

 

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