Concerns over restricting prescriptions
Restrictions on prescribing certain medicines for common conditions will exacerbate health inequalities and compromise fundamental NHS principles, the Royal Pharmaceutical Society has said. The RPS is calling for a greater focus on pharmacy minor ailments schemes instead.
The Society was commenting on the launch of an NHS England consultation on â€˜Items which should not routinely be prescribed in primary careâ€™. This consultation, which closes on 21 October, focuses on 18 items, including Fentanyl patches, homeopathy and travel vaccines. It also covers over 3,200 commonly prescribed products, such a painkillers, antifungal creams and eczema preparations, many of which are available over the counter at a lower cost than the NHS pays for them.
As P3 reported in March, the review is part of a cost saving initiative announced with the publication of the NHS Delivery Plan that could deliver efficiencies of around Â£400 million a year. NHS England chief executive Simon Stevens said that while the NHS "is probably the world's most efficient health service", there is still "waste and inefficiency that we're determined to root out".
The RPS commented that although it welcomes the consultation, and in particular the inclusion of homeopathy in the category of ineffective and unsafe medicines, it has â€œserious concerns in relation to the proposed restriction on prescribing clinically effective medicines to treat common conditions, such as head lice or athleteâ€™s footâ€.
While NHS Englandâ€™s position is that diverting money away from these treatments will help fund innovative new drugs, the RPS says such a move â€œwould fundamentally alter the principle that care is free at the point of delivery and as such should be legislated for by Parliament and not implemented by Clinical Commissioning Groupsâ€.
Minor ailment schemes: a solution?
RPS England Board chair Sandra Gidley said: â€œWe would encourage people with minor health problems to self care with the support of a pharmacist and to buy medicines where appropriate and affordable to the individual.â€Â
â€œHowever, expecting everyone to pay for medicines for common conditions will further increase health inequalities and worsen the health of patients who cannot afford them. A blanket ban on prescribing of items to buy will not improve individual quality of life or health outcomes in England,â€ Gidley said.
She argued that a more effective approachÂ would be to treat people via NHS pharmacy minor ailment schemes: â€œThese schemes enable patients to be treated for minor ailments at no cost from the pharmacy, if they already receive free prescriptions. Such schemes already operate in Scotland and Wales and should be made available across England as soon as possible.â€
Opinions from the health sector
Other bodies echoed the RPSâ€™ warning, with professor Helen Stokes-Lampard of the Royal College of GPs saying that while â€œsafe, sensible measuresâ€ to reduce costs were welcome, â€œimposing blanket policies on GPs that donâ€™t take into account demographic differences across the country, or that donâ€™t allow for flexibility for a patientâ€™s individual circumstances, risks alienating the most vulnerable in societyâ€.Â
Rachel Power, chief executive of the Patients Association, said: â€œWhile thereâ€™s merit in looking at all of these issues sensibly, the fact that itâ€™s happening now is yet another indication that the NHS does not have the financial settlement it needs from government to provide a comprehensive health service.â€
Learn how a complete regime with appropriate self-care and product recommendations can help soothe very dry skin