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GPs told to stop prescribing for minor illnesses

Somerset has become the latest CCG on a drive to restrict GPs from prescribing – with a ban on a raft of items for minor illnesses, such as throat-sprays, hair removing cream, and coughs and cold remedies.

The NHS Somerset CCG’s governing body has given the green light to the recommendation that GPs cease prescribing products for minor ailments more suitable for 'self-care non-formulary' from 1 December.

The list of 25 types of products that GPs will be stopped from prescribing also include pain killers, indigestion remedies, vitamin supplements (including vitamin D), head lice lotions, nappy rash creams and homeopathic remedies.

The CCG is encouraging patients to visit their pharmacy first and self-care for minor ailments.

Dr Ed Ford, interim chairman of NHS Somerset CCG, said: 'This difficult decision has been reached after a comprehensive review of the cost effectiveness of all areas of GP Prescribing.

'We also accepted the recommendation from the CCG’s Prescribing and Medicines Management Committee who concluded that continuing to spend over £3 million each year on such products was not a cost effective use of NHS resources.’

Dr Ford added: 'We will instead promote greater self-care by patients supported by health advice from all healthcare professionals including community pharmacies.'

The move comes hot on the heels of Somerset CCG’s recommendation that the county’s GPs should no longer prescribe gluten-free foods to people living with coeliac disease.

In October NHS Somerset CCG proposed that from 1 December people living with the disease no longer receive such foods on prescription.

At the time of the decision, Dr Ford said that 'the continued prescribing of gluten-free products is not good considered good use of scarce NHS resources'.

A raft of CCGs have issued GPs with instructions to ration services and prescribing over the last year. In just one example NHS North East Essex CCG decided to restrict a wide range of services including IVF, gluten free prescriptions, vasectomy and female sterilization.

The full list of items that GPs in Somerset will no longer prescribe

1. Hay fever preparations and travel medicines

2. Pain killers for minor aches and pains

3. Soluble pain killers (because of high salt content)

4. Treatments for non-serious constipation or diarrhoea

5. Creams, gels, oils and dressings for minor sprains, sports injuries and scars

6. Moisturisers and bath additives for minor dry skin conditions; sun creams

7. Indigestion remedies for occasional use

8. Athletes’ foot creams and powders

9. Tonic, vitamin, and health supplements – including vitamin D supplements

10. Nappy rash/barrier creams; Hair removing creams; antiperspirants

11. Lozenges, throat sprays, mouthwashes, gargles and toothpastes

12. Treatments for minor facial spots

13. Treatments for fungal skin, nail infections and dandruff

14. Cough and cold remedies

15. Nasal decongestants (and Sterimar)

16. Topical treatments for vaginal thrush

17. Slimming preparations (except within national guidelines)

18. Foods and toilet preparations except where clinically indicated, cakes; cake mixes and biscuits; ready-made thickened juices; soya milks

20. Threadworm tablets

21. Treatments for warts and verrucas

22. Creams for bruising, tattoos, varicose veins and scars

23. Head lice lotions and shampoos (wet combing is recommended)

24. Ear wax removers (a few drops of olive oil is just as good as anything on prescription)

25. Homeopathic remedies

Source: NHS Somerset CCG

Readers' comments (32)

  • Does that mean Dr Ford will answer all the complaint letters? Where do we forward them to?

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  • You could argue all day about this list couldn't you? The prescribing ban on some is pretty easy to justify, like homeopathy (of course!), lozenges, toothpaste etc. But some are much harder to palate I think. You stop GPs prescribing athletes foot creams to the lower income patients, you are going to get more bacterial secondary infections and only one of those needs admitted with a raging cellulitis and you have lost both the short-term cost saving, and also (more importantly) the good will and trust of patients.

    I work in Scotland where scripts are free and I could do with a ban on prescribing hayfever remedies and minor analgesics here. This list seems too extreme to me though.

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  • Just say no already folks. The GMC Good Medical practice guidance requires you to consider cost effectiveness in prescribing and the OTC availability covers your liability. Grow a pair.

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  • Not my job to decide who should pay for treatments and who shouldn't. Check your contract. A patient may refer u to the GMC if u advise a treatment but refuse to provide it. Where will the CCG be then?

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  • As long as this is a ban and widely publicised and not the usual weasely recommendation which leaves GPs to take the flack.....,

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  • PHE - produce a definitive list, publish it everywhere and in all the papers so EVERYONE knows it's contents and then we might stand a chance. "GP is best placed to discuss… etc etc" will end up with more hassle, complaints and sorry but we haven't got the time to fight every demanding DM reader until this is in black and white and signed off by Jezza and made law. It is the only way there is a chance it could possibly work.

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  • All part of Hunt's great plan - did he not say he does not feel there is indication for anything to be rationed or cut but GPs run CCGs and therefore he is powerless to stop the money-grabbing golf-playing GPs cutting services and now medications. GPs really are the scourge of the Earth - line us all up and shoot us, save the World from the scum that is GP,

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  • Vinci Ho

    (1) I think we all know this reality will bite sooner or later.
    (2) No whisful thinking from the Chancellor in tomorrow's Autumn Statement for NHS
    (3) No chance NHSE,PHE or DoH will make a list like this official and tell people will have to pay,especially Agent Hunt is such a good , honest SOS
    (4) Scapegoats are scapegoats. May be there are some willing to be scapegoats and others not so willing . So what? You have no say . GPs are CCGs, CCGs are GPS, thanks to Health and Social Care Act and Lansley.

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  • The previous clampdown and GMC threats around antibiotic prescribing was fantastic. This is long overdue, will make the job of GPs easier and save NHS money. More please! Can I please be banned from prescribing diazepam or sleepers for more than 3 days or giving morphine type meds to patients who don't have cancer. There is a lot more that we could do, just don't lay the blame onto the front line staff.

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  • Once the GMC will support a doctor for not prescribing paracetmol/hayfever medications/ring worm/ibuprofen/self limiting illness medication, I might consider this. Once I have complete immunity that might arise for the complaint to me/nhse/cqc/GMC for doing this, I might consider it. Until the, this guidance will change sweet faf all. Thanks for trying

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