NHS Blackburn with Darwen CCG

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Proposals to stop prescribing medicines for minor conditions

This consultation is now closed. From 3 July 2017, the CCG has approved restricting the prescribing of treatments and medicines  for short-term, minor conditions.

The findings of the consultation are listed below:

Prescribing for Clinical Need Policy – Evaluation Report
Appendix 1 — Consultation Document and Survey
Appendix 2 — Qualitative Data
Appendix 3 — Media Coverage
Appendix 4 — About You – Equality Monitoring
Appendix 5 — Digital Report

NHS Blackburn with Darwen Clinical Commissioning Group continuously reviews the services it commissions or “buys” to ensure that the local health budget is spent as effectively as possible, whilst minimising waste and promoting self-care.

The CCG is proposing to stop prescribing treatments and medicines for short-term, minor conditions or where there is insufficient evidence that they improve symptoms or where they aren’t value for money.

Many of these medicines are now widely available over the counter (in pharmacies or shops) at a low cost price or cheaper than an NHS prescription. Many are prescribed for conditions that have no clinical need of treatment.

The CCG wants to encourage people to “self-care” — which means that people take more responsibility for their own health and wellbeing where they can. For instance pharmacies are a good source of advice and support and can release GP time to treat people with more serious conditions.

The CCG wants its limited medicines budget to be used for the treatment of more serious conditions. It currently spends £663,042 a year on prescriptions for items that are available over the counter for self-care and wants your views on its proposals to stop these prescriptions in the future.

Why are we proposing to stop prescribing medicines for minor conditions?

Self-care is when people manage simple, short-term conditions themselves, e.g. sore throats and colds. This is widely acknowledged as an important solution to help keep the NHS sustainable. Nationally there are 57 million GP consultations each year for minor conditions and this costs the NHS approximately £2 billion and takes up to an hour a day on average for every GP.

Removing medicines for short-term, minor ailments from routine prescription would free up GP time to treat patients with more urgent or serious medical problems. Most minor ailments are generally not of a serious nature and can usually be effectively managed by the individual, parents or carers.

Products aimed at treating the symptoms of many of these ailments may not offer value for money and should not normally be prescribed at NHS expense — simple medications are prescribed at an inflated cost to the NHS and take up clinical and patient time.

Often these products are widely available at low cost from supermarkets and pharmacies. Pharmacists (and other trained staff) are experts in providing advice around minor ailments; they are easy to access without an appointments.

Conditions where there is no clinical need of treatment

Conditions such as a common cold, sore throat or minor cough are ones that would naturally get better themselves in the majority of patients if untreated, and so products to help soothe these conditions (e.g. cough mixtures, sore throat lozenges) will no longer be prescribed. Treatments for minor ailments, such as vaginal thrush, can be treated with medicines from the pharmacy, and so will also be removed from prescriptions.

Products where there is insufficient evidence of clinical benefit or cost effectiveness

Some products that we currently prescribe are clinically ineffective or are not cost effective. These treatments will not have undergone rigorous clinical trials to demonstrate that they work. We believe that it is inappropriate to spend our local NHS budget on products that do not have proven efficacy or safety in preference to medicines supported by robust clinical evidence.

NHS Blackburn with Darwen CCG already has policies in place to limit the prescribing of some of these products, (e.g. glucosamine supplements, vitamin products specifically for eye health, and homeopathic remedies). Further policies will be developed as other products with limited evidence to support them are identified.

Examples of ‘over the counter’ items which we are proposing to remove from prescription as are shown in the list below (this is not an exhaustive list) and details of what we spent on prescribing these items in 2015/16.

Category Spend

Simple pain relief £232,336

Antihistamine tablets, capsules, liquids and sprays £71,664

Antifungal nail £8,684

Athletes Foot £5,503

Health supplements £25,981

Bites and Stings £34,382

Conjunctivitis £8,900

Dandruff – Cradle Cap £27,779

Diarrhoea £33,268

Indigestion/heartburn £74,469

Sore throat £5,918

Nasal decongestant £3,536

Sunscreens £7,181

Headlice £24,261

Teething £6,110

Warts and verruca treatments £1,492

Antiperspirants £1,149

Emollients £40,679

Cough syrups £3,494

Ear wax removers £5,367

Have your say 

NHS Blackburn with Darwen CCG is undertaking consultation on the proposal so it can explore the issue in more detail and obtain feedback from patients and the public. The consultation will run from Monday 30 January 2017 until Friday March 31 2017.  

All residents of Blackburn with Darwen or those registered with a GP in the borough have the potential to be affected. After the period of consultation, all feedback will be used to produce a report with recommendations that will inform the CCG’s decision in relation to implementing the proposals.

Getting Your Feedback

As part of the consultation we need your views on the proposals and to understand the impact they may have on you. To hear what you think about the proposals you have a variety of opportunities to give your feedback.

POST - You can fill in the survey below and post back to our address Blackburn with Darwen CCG, Fusion House, Haslingden Road, Blackburn, BB1 2FD.

ONLINE — by following the link to the electronic survey below: https://www.surveymonkey.co.uk/r/MX3RRJZ

EMAIL – send your completed surveys to communications@blackburnwithdarwenccg.nhs.uk

Self Care Questionnaire — Word (docx | 44.0 KiB)


Compliments, Complaints or Comments

The Customer Care Team can offer help and support . They can be contacted on the following:

Customer Care Team, Jubilee House, Lancashire Business Park, Leyland, PR26 6TR; Freephone:  0800 032 2424; Telephone:  01772 777952; Textphone:  01772 227005; Email: mlcsu.customercarelancashire@nhs.net