Last year saw several local Clinical Commissioning Groups (CCGs) put prescribing restrictions in place for their local populations, and the first stage of a consultation by NHS England and NHS Clinical Commissioners on guidance to try to reduce variation across the country. In the PAGB’s response to this, we objected to long-term conditions being included in prescribing restrictions and I’m pleased these were taken out of scope in the second phase of the consultation, launched before Christmas.
December’s revised proposals look specifically at the conditions for which OTC medicines should not routinely be prescnbed. These are conditions that are either considered to be self-limiting and so do not need treatment or which lend themselves to self care, with advice from a local pharmacist or use of an OTC medicine. In the year to June 2017, the NHS spent £569 million’ on prescription items that could have been purchased OTC, usually at a much lower cost to both the NHS and the individual.
It is PAGB’s view that restricting the availability of prescriptions for self-treatable conditions without offering people any support to self care isn’t going to change behaviour in the long term. With a third of people (32 per cent) still visiting the doctor instead of a pharmacist for seasonal conditions such as coughs, colds and sore throats, it’s evident that people need more education on how to recognise the different symptoms of common conditions and more support to self care appropriately. If we don’t provide this, people may end up back in the GP surgery or A&E asking for a prescription medicine.
To fully realise the potential for self care, PAGB believes we need a national strategy for self care with initiatives to encourage self care behaviour, such as allowing pharmacists access to write in people’s care records, offering GPs recommendation pads, so they can recommend rather than prescribe an OTC medicine (as has been very successful in Germany) and running a national public health campaign to promote the expertise of pharmacists. PAGB is fully supportive of the ‘three before GP message from the Royal College of GPs which encourages people to ask themselves three questions before booking a GP appointment – Can I self care? Can I look for information on nhs.uk? Or can I ask my local pharmacist for advice?
I am really pleased to see such a positive self care message from the GP community.
Reducing the number of prescriptions for self-treatable conditions is a small part of the self care agenda, but if it is implemented in conjunction with other measures to empower more people to self care, it could help ensure that limited NHS resources are used in the most effective way.
This column first appeared in P3 magazine.