PAGB has responded to NHS England and NHS Clinical Commissioners consultation on ‘Items which should not routinely be prescribed in primary care’ arguing that introducing prescribing restrictions before implementing measures to support greater self care could result in unintended consequences which would place a higher burden on NHS services and calling for greater clarity about the next stages of the consultation.
PAGB is concerned that NHS England and NHS Clinical Commissioners are missing an opportunity to empower people to self care in a sustainable way that will lead to a reduction in GP appointments and A&E visits for self-treatable conditions, as well as making savings on the prescription bill. Increasing people’s capacity to look after their own health and wellbeing and reducing their dependence on NHS services for conditions which can be self-treated with the advice of a community pharmacist has the potential to release more than £2 billion of efficiency savings. A system-wide approach is needed.
A national strategy for self care is required to provide the leadership and policy coordination to implement a range of measures to better equip people to self care. If prescribing restrictions are introduced, the implementation should be timed to first allow other self care initiatives to be embedded first.
A summary of PAGB’s submission is below:
- It is vital to promote and empower more people to self care, rather than use GP and A&E services for conditions which could be self-treated at home or with advice from a pharmacist.
- Taking a system-wide approach to self care has the potential to release greater efficiency savings (> £2bn) than those outlined in the consultation document.
- A national strategy for self care is required to provide the leadership and policy co-ordination necessary to embed self care into the NHS and people’s lives.
- Measures which should be introduced under a national self care strategy should include:
- policies to make it easier for people to buy over-the-counter (OTC) products e.g. reducing the VAT rate and increasing the number of medicine reclassifications;
- offering GPs ‘recommendation pads’ so they can recommend rather than prescribe OTC medicines;
- tools to empower pharmacists to support self care;
- action to improve health literacy and steps to support people to live healthier lives.
- Introducing prescribing restrictions before implementing measures to support greater self care could result in unintended consequences which place a higher burden on NHS services.
- Safety and efficacy should not be assessment criteria for prescribing restrictions. OTC medicines on the market in the UK have demonstrated clear evidence of a good safety profile, efficacy to treat the condition it is indicated for and suitability for self care. Any concerns about the safety of medicines should be addressed through existing MHRA regulatory processes.
- It is important that healthcare professionals continue to have the ability to use their clinical judgement in making prescribing decisions, particularly with regards over-the-counter medicines that are prescribed for the treatment of long-term or serious conditions, or to prevent illness and disability (and therefore NHS costs) in the future.
- Greater clarity is needed about next stages of consultation. PAGB can bring insights and value to future discussions on this guidance. We would therefore welcome the opportunity to participate on the joint clinical working group which is developing the proposals.
Read our previous press release about this consultation.