Over The Counter OTC & Gluten Free Foods Policy update for NHS staff Herefordshire CCG & Providers 1st October 2018
OTC and gluten free foods update OTC medicines &Gluten Free foods Added to Herefordshire Treatment Policy i.e. low priority for funding not to be routinely prescribed Herefordshire patients 1st October 2018 Align with Worcestershire, Shropshire and Gloucestershire Wales low use OTCs on “free prescriptions for all”
What are Over The Counter (OTC) medicines ? Some are General Sales List (GSL) medicines Antihistamines, paracetamol, ibuprofen, emollients Non medicines , devices Widely available at supermarkets, convenience shops, discount shops Wide range of prices <£5, pharmacy, supermarket to discount shops Pharmacies can provide medicines advice and supply a wider range & larger packs Exceptions Some OTC medicines may be restricted due to license e.g. larger pack sizes, or cannot be sold to some groups e.g. in pregnancy or for children
Why shifting OTC to self care? Free up NHS capacity and is part of care navigation approach to minor ailments self care Community pharmacy advice & supply Free up primary care time for complex long term conditions NHS saving in staff resources & prescribing costs over £1m/year to be reinvested in patient care In line with NHSE national consultation 2017 In line with local CCGs ie Worcestershire & Gloucestershire Prescription Exemption status – most items cost less than a few pounds & are readily available at many retail outlets Note - there are some exceptions
In line with national guidance, HCCG proposes exceptions to the policy : patients prescribed an OTC medicine for a long term or more complex condition. There are some grey areas eg elderly on regular paracetamol 100s patients on prescription only items eg antihistamines recommended by NHS specialists eg cancer care where a clinician considers that a patient’s wellbeing could be affected due to health, mental health or significant social vulnerability
What's available Local Store Rural village OTC range Indigestion Coughs & colds Teething Analgesia Children's options
Common OTC patient costs vary OTC price range Lowest* Higher** Antihistamines ie cetirizine, loratadine, many others (30 pack) 89p £7 plus Ibuprofen suspension 100ml 99p £3.99 Paracetamol suspension 100ml £1.20 £3.79 Bongela teething gel £2.49 £3.99 Infacol £2.95 £3.13 Dentinox colic drops £2.29 £2.85 Aciclovir cold sore cream 59p £4.89 * Local survey discount shops **RRP or other
Outcomes from other areas Reduced demand for appointments & prescriptions across all care areas Freeing up capacity in primary care & community services Realign capacity eg more patient support for long term conditions Promote self care Less patient dependency Greater Equity Well received to support NHS pressures
Local engagement survey 2018, 200+ responses 1. Do you agree that we should restrict prescribing medicines for short-term minor conditions and ailments?
Support for HCPs & patients HCCG Web site information Web Quick reference guidance for HCPs from NHSE & NHS clinical commissioning Patient information posters & leaflets eg hayfever, colic Care Navigation EMIS templates and “A-Z of how your pharmacist can help you” HCCG Communications e.g. press release, Twitter.
Self Care Resources at GP practices, pharmacies, community hospitals Herefordshire posters & PILs Or See Herefordshire CCG web pages https://www.herefordshireccg.nhs.uk/your-services/medicines- optimisation/prescribing-guidelines/low-priority-medicines/over-the-counter- products-otc
Gluten Free Food on prescription Herefordshire no longer supports the supply of GF foods on prescription: Freely available in various outlets Cost less & much less than on prescription Reduce NHS waste expired products eg bread Increase equity <20% coeliacs use prescriptions exceptions to the policy as per NHSE OTC Coeliac pathway focusing on identifying unknown people and also annual reviews Note – NHS England plans to retain key products eg bread and mixes
2. Do you agree that we should stop prescribing gluten free foods?