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

The cost-cutting measure could see the end of medications like co-proxamol, fentanyl and lidocaine plasters.

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’;

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.