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The waiting game

Homeopathy prescribing set to be blacklisted under NHS England plans

NHS England has said it is going to 'formally request' that the Government ban GPs from prescribing homeopathy.

In 2017, NHS England published guidance to stop prescriptions for 18 low clinical priority treatments including homeopathy given the lack of 'clear or robust evidence'.

In addition to existing guidelines, NHS England has now said it will 'formally' request the Department of Heath and Social Care (DHSC) to blacklist homeopathy to make sure available funding is better used.

If the DHSC go along with NHS England's recommendation, then homeopathy would no longer legally be prescribed in primary care settings. 

An NHS England spokesperson said: 'The NHS has issued guidance making it clear to GPs that homeopathy should not be prescribed, and to give further legal force to this we will now be formally requesting that the Department of Health blacklist it so that funds cannot be wasted in this way.'

A DH spokesperson said: 'We expect GPs to prescribe treatments for the clinical benefit of their patients. In line with the clinical evidence on the effectiveness of homeopathy, NHS England issued guidance to prescribers on the use of various items of low clinical value, which has resulted in a decline of homeopathic prescribing in primary care of 52%.

'We will consider NHS England’s request and respond in due course but we would expect doctors to be following these guidelines already.'

GPC clinical policy lead Dr Andrew Green previously called on the Government to ban over-the-counter or low-value medicines, rather than having guidance alone, as this would be ‘wholly inadequate’ and could put GPs at risk of breaching their contracts.

There is already a blacklist of drugs that GPs may not prescribe, which appears under Schedule 1 of the 2004 GMS contract.

The list, which includes drugs that experts agreed had no clinical or therapeutic advantage over other cheaper drugs, was first set up in 1985 and no new items have been added since 2004.

Last year, the High Court rejected a legal challenge brought in by the British Homeopathic Association to overturn NHS England plans to no longer routinely fund homeopathy.

NHS England welcomed the court victory, with chief executive Simon Stevens calling the legal challenge ‘costly and spurious’ and stating that homeopathy is a ‘misuse of scarce NHS funds’.

This came after research found that over 2,700 homeopathy prescriptions were issued by GP practices between December 2016 and May 2017, costing a total of £36,532.

Meanwhile, researchers revealed that GPs are writing one million fewer prescriptions for low-priority treatments but that price hikes have led to a rise in the overall spending.

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Readers' comments (26)

  • Hallelujah!

    Long overdue

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  • David Banner

    Finally NHSE have the courage to blacklist sterile water on prescription.
    So if you want us to cut out all the OTC drugs, front up and blacklist them too, and stop passing the blame (sorry, “issuing guidance “) to GPs

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  • About time. I always thought anyone prescribing homeopathy should be stripped of their licence if they didn't realise the stupidity of their position after retraining. Quackery does our profession a disservice.

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  • Apart from homeopathy there is an amazing list of drugs banned from prescribing on this list, e.g.:

    Cabdrivers Diabetic Linctus
    Do-Do Tablets
    Dove Cleansing Bar
    Dr Brandreth’s Pills
    Dr D E Jongh’s Cod Liver Oil with Malt Extract & Vitamins Fortified Syrup
    Dr William’s Pink Pills
    Dragon Balm

    Which GP in the history of the universe has ever prescribed these products?

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  • The GMC is quite clear about respecting colleagues, and about patients' informed consent, so when colleagues consider a particular treatment appropriate it behoves us to be respectful- you do realise the NHS spends £266 million a year on SSRI's which are research proven placebo equivalents in mild and moderate depression? At least homeopathic drugs are safe and cost-effective. Do respect your colleagues.

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  • |Do good | GP Partner/Principal|10 Apr 2019 9:26am

    1. You're just about the only person that takes the GMC seriously still.
    2. Snake oil salesmen are not our 'colleagues'.
    3. 'cost-effective'? for a placebo effect? You might be happy for your taxes to be frittered away as such, but not everyone is. Hey I'm against extensive prescribing of SSRIs too.
    4. If a patient with 'informed consent' wants to try something 'unproven', they can pay for it.

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  • Hold on Chris- If prescribing SSRIs for mild and moderate depression makes me a snake oil salesman, am I still your colleague? What are your intentions here?

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  • Easy, to reduce the size of state and taxpayer spending in general, and in healthcare, starting with anything non-medical, unproven, non-essential etc. The evidence for homeopathy is that its quackery. If the evidence for SSRIs is that poor, let the individual/free market decide if they want to spend on it. Also, there's no point trying to lump SSRIs and homeopathy together. There are guidelines for SSRIs, whilst currently, NICE doesn't recommend that homeopathy be used in the treatment of any health condition.

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  • Also, about respect. I'm pretty old-school in some sense in that I believe respect is earned. I certainly can't be commanded or compelled to respect others, it is voluntarily given. You would like to assume that your fellow doctors have earned that too, but surely you can think of many circumstances when that's not always the case. It comes down to definitions really. If what you mean by respect is 'treating someone with dignity', sure but that doesn't absolve them from criticism of their ideas.

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  • Completely agree with and endorse the views of Do good. The vile authoritarian views also expressed here are disappointing. Homeopathy is NOT quackery. OUTCOME STUDIES show very convincing clinical results (eg Spence et al) Any doctor with a conscience would be mindful of that and recognise that homeopathy (which includes an in-depth holistic consultation does indeed work - even though HOW it works is most certainly open to debate. Countries such as Switzerland show a much more tolerant view of this and the view of its citizens. Of course any doctor who does harm by not using conventional treatment when it's really needed, can and will be disciplined. It is to homeopathy's credit that this very seldom happens and doctors using alternative medicine are in the lowest bracket of fees for indemnity insurance which shows that actuaries and people who study statistics rather than express their opinion vituperatively seem to understand the 'danger' of doctor using CAM a bit more intelligently. Unfortunately here we don't seem to care much about what the people want and what they say they want. This is unfortunate for a country in which great liberals such as John Stuart Mill once walked.

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  • |Liberal Doctor | GP Partner/Principal|10 Apr 2019 11:15am

    So NHSE and NICE are now both vile authoritarians, some agreement there lol Homeopathy is hardly 'conventional' now, you're really pushing it. And you're using punitive action to threaten our individual autonomy? I'm sure you'll go places with that. Oh sure, doctors using homeopathy are in lowest bracket of indemnity insurance as there's no harm in drinking sterile water. I'm not debating the benefits of improved doctor patient consultations. Or that people shouldn't be able to PAY for what they want. I'm just contending that the taxpayer shouldn't be compelled to pay for it. As for your last throwaway comment, liberalism meant quite differently then, compared to what it has become now.

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  • The United Kingdom has an obligation to respect and promote the right to freedom of expression and information as set out in Article 19 of the International Covenant on Civil and Political Rights and Article 10 of the European Convention on Human Rights, amongst other international treaties.

    The proposals also risk breaking binding international law. The UK is a member of the International Covenant on Civil and Political Rights. And Article 19 states:

    1. Everyone shall have the right to hold opinions without interference.

    2. Everyone shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of his choice.

    and how are colleagues & NHS England not bound by all this?

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  • @Do good
    I don't agree with what you say but I defend absolutely your right to say it.
    Having said that I think everyone should calm down and have a nice glass of water.
    It does at least have some proven physiological benefits.

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  • |Do good | GP Partner/Principal|10 Apr 2019 1:59pm

    I'm not sure what you're going on about here. Nobody is saying you're not free to express your opinion, but as per "this right shall include freedom to seek, RECEIVE and impart information and ideas", anyone is also free to criticise it. Plus, it is clear that we don't live in a free-speech state. Just ask Tommy Robinson.

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  • Anyone who thinks this is about the money is very wrong or very disingenuous. This is an attempt to discredit homeopathy, nothing more and nothing less.

    The bottom line is that we still believe in this country that doctors are better placed than academics to make clinical decisions about their own patients. The doctor-patient relationship is vital. If a substantial minority of people in the UK (including Queen Elizabeth II and much of her family and corgies) use homeopathy and want it prescribed for them by medical doctors, then the NHS should most certainly fund these ecologically sound and highly inexpensive medicines although I'm prepared to debate whether the Royal corgies should have to pay for it themselves. The Swiss actually voted for this principle in a referendum and I believe a democratic vote here would not deny CAM for those patients who want it and whose NHS doctors would be prepared to prescribe it and take responsibility of their decisions. Last Thing: If you are going to make jokes about homeopathy here, can you please raise the standard and stop repeating very old and stale gags.

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  • @Christopher Ho I did NOT say that NHS or NICE or CCGs are vile. I may disagree with their recommendations but while they are only recommendations I can live with them. But to BLACKLIST (which is what is being suggested) is what would be foul authoritarianism.

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  • |Liberal Doctor | GP Partner/Principal|10 Apr 2019 3:36pm

    Of course its about the money, to ignore that is why 'liberalism' or more accurately, 'socialism' is currently so unpopular. 1. We're broke. 2. We want universal treatment, but we do not have infinite resources, result? we ration. For a 100 people to be prescribed homeopathic treatments maybe 1 or more elderly patients might not get their hip replacement before their death, or your mother might be denied life-saving new breast cancer treatment. By all means, doctors might be fine with their patients trying unproven treatments, but that doesn't mean it should be funded by the taxpayer, thankfully we still have some rational minds looking at cost effectiveness. If you're prepared to debate whether corgies should have to pay for themselves, then you're prepared to debate whether everyone should have to pay for themselves then. Unless you're saying just because someone wants something on the NHS, then they should get it (even the Queen!). Doctors can take medical responsibility for decisions sure, but not the responsibility for financial repercussions surely. I wonder what old and stale gags you're referring to... Blacklisting only results in the taxpayer stopping funding of it, its not denying people access to it privately. That's hardly authoritarianism, or you seriously don't know what true authoritarianism is.

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  • It's quite clear to anybody disagreeing with you, Christopher Ho, that this issue is NOT about money. The figure is miniscule. In today's news is an article suggesting that psychotherapy can be effective in IBS - something obvious to holistic doctors for several decades. I believe homeopathy works but even those who think that it's the consultation quality and some sort of 'hypnosis' is the therapeutic ingredient, even then it would be cruel to act like this. Fact is that OUTCOME STUDIES show that people seeing homeopathic doctors do get better and it's cost effective. Another fact is that it appears to work on animals and yet another that in India there are over 350K qualified homeopathic practitioners and a minister in the government for homeopathy and CAM. And yet another is the Swiss decision to let the people decide for themselves on this issue - as opposed to being told they are deluded by people such as yourself.

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  • You don't seem to get the point either LD. I'm not saying people should be barred from accessing it. I'm saying the taxpayer shouldn't fund it. Religious circumcisions on the NHS make 100% of families who make their sons get it feel better. Cosmetic breast implants make 100% of women who get it feel better. Escorts on personal health budgets make 100% of those who receive them feel better. That's your argument - just because it makes someone feel better means the taxpayer should fund it.... I'm all for people deciding for themselves, and then fund it themselves. And you say its miniscule? Well, you know the immortal words via Tesco - every little helps :) Plus, its obvious to anyone who's not a socialist, that to you, it's always easier spending someone else's money. And via Margaret Thatcher - The problem with socialism is that you eventually run out of other people's money.

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  • Oh by the way, the private sector provides most of the healthcare provision in India, not via the state or even insurance but straight out of the pockets of individuals. Just so you know.

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    Miniscule you say?

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  • So Chris, back to £266 million being spent on drugs with side effects and withdrawal issues, proven to be equivalent to placebo, in the increasingly common conditions of mild and moderate depression-reportedly increasing- how could that dosh be better directed or should the NHS be spending even more on these placebos every year?

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  • @Do good. The NHS HAS been spending more on placebos every yr. I contend that the state spending taxpayers' money is far less effective than individuals deciding for themselves in a free market. Now there are some minimal requirements of the state, security, judiciary, maybe even emergency healthcare provision, education for those below the poverty line, stringent base welfare. But clearly in some sectors, our state is too big. I would give that money, and much more back to its original owners, the taxpayer. And reduce the size/power/spending of the state.

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  • Chris- you now sound like a homeopathic doctor- the Faculty of Homeopathy has been running courses for people like us for nearly 70 years- even an FRCGP wrote a concise handbook- Dr Jack- have a peek- only £3.29 on e-bay- wouldn't even break the NHS bank, and would be v. interesting to hear your critique once YOU HAVE READ IT, please?

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  • What BS. How do I sound like I'm peddling sterile water on taxpayer funds? How about you read Milton Friedman, Thomas Sowell, Aleksandr Solzhenitsyn, Jordan Peterson, Christopher Hitchens, then let's see your critique? In case you haven't realised, the NHS bank IS broken!

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  • What brilliant stuff indeed.....

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