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Patients resort to stealing Calpol: How the cost-of-living crisis is affecting GP prescribing

Patients resort to stealing Calpol: How the cost-of-living crisis is affecting GP prescribing

Emma Wilkinson finds how GP practices are having to support patients who can’t afford basic medicines

Calpol is the most shoplifted item in one area of East London, the headlines blared, with the cost-of-living crisis leaving people unable to afford even the most basic medicines, a situation the local Mayor described as ‘utterly devastating’.

Indeed, GPs around the country have told Pulse that they are seeing more and more patients coming to ask for prescriptions for over-the-counter (OTC) medicines for minor conditions because they simply have no money to buy them.

From paracetamol to antihistamines, emollients to eye drops, patients who could or have tried to get help at the pharmacy are coming to the GP because they cannot pay for the medicines they are being advised to take.

Patients get stuck in a loop moving from the practice to the pharmacy wasting everyone’s time, say GPs. General practice and community pharmacy are in strong agreement that there is an urgent need to put something in place to help the most vulnerable people manage minor illnesses.

Wales, Scotland and Northern Ireland already have Pharmacy First schemes in place and pharmaceutical negotiators (PSNC) in England have been lobbying hard for a similar fully-funded pharmacy walk-in service.

They estimate there are 36 million consultations in English pharmacies every year where the person would have otherwise gone to the GP or A&E. In a briefing to ministers last month PSNC said they are ready and willing to divert patients with minor illnesses away from GPs who are under ‘unprecedented pressure’ but cannot do it without funding.

Minor ailments schemes

Go back less than ten years and minor ailments schemes were in place across the country. Yet NHS England’s ban in 2018 on spending on OTC medicines led to most schemes being decommissioned as not good value for money.

The Community Pharmacy Consultation Service (CPCS) introduced in 2019 is often no help to those on the lowest incomes because they have to pay for the medicines so end up getting referred back to the GP, notes Dr Richard Vautrey, assistant medical secretary at Leeds LMC.

‘This is a big issue, particularly in the midst of the cost-of-living crisis. It is one of the flaws of the CPCS as patients who would otherwise get a free prescription may be asked to pay for the same item when directed to the pharmacy.

‘Pharmacy First schemes with a clear list of items provided free to eligible patients are fairer and the community pharmacy scheme needs to be reformed so patients get the same free treatments wherever they are seen.’ 

Post-pandemic the decommissioning of minor ailments schemes seems incredibly short-sighted and GPs in the most deprived areas are seeing the impact every day, says Dr Selvaseelan Selvarajah, a GP in Tower Hamlets, the area where Calpol thefts hit the newspapers.

While patients in the more affluent parts of London may not have even known the minor ailments service existed, more than half the children in the borough live in poverty and people relied on it, he adds.

‘That headline about Calpol being the most stolen item is just so tragic and there is no need for that to happen.

‘We do total triage and often when you signpost patients to the pharmacy you get a message back saying I can’t afford eye drops or Calpol and that is not something we saw back in 2018. I prescribe because it is the right thing to do.’

But he adds the absence of a proper minor ailments scheme – as well as harming patients – costs more in the long run. ‘It is more expensive for the system overall because you get patients just bouncing around the system.’

Tower Hamlets LMC and others in North East London have been campaigning for some sort of minor ailments to be reintroduced and they are having ‘positive’ conversations with the ICB who know there is a real problem but need to find the money.

He believes that NHS England are so distracted by the recovery that it will prove more fruitful to work with local commissioners to get something in place – perhaps even restricted to the most deprived areas.

There are some small local schemes still dotted around. Dr Paul Evans, a GP in Gateshead said patients being unable to afford over the counter medicines is ‘absolutely’ a real problem. ‘We do, however, have a local pharmacy scheme that enables them to get certain OTC meds free.’

But in Sheffield Dr Susie Lupton, a GP in one of the most deprived areas of the city says having a local scheme in place is not always enough.

‘We do have a minor ailments scheme for some patients in Sheffield and have done so for many years.

‘However, it really depends how good your local pharmacy is so patients still ask us and use up many appointments in poorer areas.’ 

She adds that shortages of pharmacy staff and they pressures those teams are under compounds the problem. ‘If this is say 20 patients a day for us then how can one pharmacy cope with that volume.

‘Pharmacies also often run on locums and some may not have done the training to do minor ailments and then patients we have signposted come back to us, it’s a farce and wastes everyone’s time.’

Dr Lupton says they also see many working people who cannot afford their prescriptions. ‘We have had people who have delayed getting antibiotics and ended up in hospital or stopped chronic disease medication with likely life shortening results. This is not new but it is worsening.’

ICBs decommissioning services

In Nottingham, a Pharmacy First type scheme which had been in place for two decades came to an end in March when the ICB chose not to continue the service.

Local pharmacy representatives warned this had come at a time when people could least afford it and had tried to put forward options for keeping it in place.

Dr Hussain Gandhi, a GP in the city said he had definitely noticed an impact. ‘The number of patients contacting for eye drops for minor irritation, scabies treatments and hayfever treatments has risen significantly and blocking access for other patients.

‘There has also been a rise in those asking for paracetamol and ibuprofen on prescription, especially for children.’

The RCGP say solutions need to be found so that all patients can access the care they need.

RCGP vice-chair Dr Victoria Tzortziou-Brown, told Pulse:‘It’s concerning to hear that some patients are being priced out of being able to look after themselves by taking the initiative to buy over the counter products, instead of going to the GP, but not being able to afford them.

‘This is, unfortunately, becoming the reality for some of the UK’s more deprived communities which have seen worsening health inequalities.’

She adds: ‘GPs are witnesses to the impact of the rising cost-of-living crisis on patients, many of whom are struggling to maintain their physical and mental health with the high prices of necessities like food and heating. It is our most vulnerable patients who are suffering most.’ 

Read more on our sister title, The Pharmacist: ‘Utterly devastating’: Cost-of-living crisis hits OTC medicines access


Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.


Please note, only GPs are permitted to add comments to articles

Matt Hancock 4 May, 2023 6:24 pm

This is not our fight. The NHS will give you this directive but still allow prescribing. If you dont want us to issue otc medications then just invalidate the prescriptions when they get to the pharmacy.

Right now the policy leaves us open to complaints and emotional blackmail.

I will continue to prescribe for thrush, hayfever etc.

David Church 4 May, 2023 6:32 pm

What a comment on the stte of (un-) civilisation in Britain today !

David Mile 4 May, 2023 7:02 pm

I am a retired GP.
For many years , colleagues argued that we shouldn’t prescribe Calpol. I disagreed and still do. Calpol is an important medicine for children and so they should be entitled to it for free. Financial considerations should not come into this especially as Calpol is not an expensive drug. It relieves discomfort and disease. Once again families with children who are financially vulnerable are being penalised.

Anonymous 4 May, 2023 8:01 pm

David Mile – completely disagree with you.

Calpol costs approx £3.5 and prescribing it on the NHS is just an utter waste of resources.
Paracetamol tablets are just 30p.

Vulnerable families can skip one trip to McDonald’s a month to buy Calpol, if they just use their brain.

Agreeing to prescribe paracetamol and ibuprofen just fuels their sense of entitlement and absolves them of any sense of responsibility for their own health.

Matt Hancock 4 May, 2023 8:01 pm

The though process is that by issuing otc medications you are encouraging patients to use up appts to get their free prescriptions. I often have adults booking in with simple eye infections or thrush

David Banner 5 May, 2023 6:59 am

The posts above demonstrate just how ludicrous the current situation is. If the DOH doesn’t want us to prescribe OTC meds, then they have the power to ban them from FP10. But no, instead they leave us with both the ability to prescribe whilst advising us not to prescribe, leading to the nonsense of some GPs prescribing, others not, which is ridiculous for patients and GPs alike. Make your mind up, DOH, what’s it to be?

Adam Crowther 5 May, 2023 7:30 am

Another example of terrible social and educational policy for the most vulnerable. Families go to fast food establishments because it is all they know and the reality is they can stack up on calories at fraction of the total cost of preparing a meal. I would like to see our most vulnerable provided with a homely remedies box with all of these occasional health essentials provided for free and replenished for free when out of stock and most importantly helped to identify what and when to use. Gosh it may be even more important than doing maths until age 18 🤦🏼‍♂️😢

Liam Topham 5 May, 2023 9:14 am

Adam I have to disagree with you – much cheaper to prepare food – whatever your diet
sausage mash and peas, chickpea curry with rice and veg, they are practically giving British mackerel and trout away – seemingly nobody can be bothered eating them because they have a few bones!
a meal for four at Nandos / KFC / Macdonalds etc will set you back a fair bit – and its total rubbish

Not on your Nelly 5 May, 2023 11:42 am

I wish retired GPs , who have no idea what it is like on the ground, stop posting on here. It is different now for working GPs than it was in your time. You are not part of the system so have no say in how people working on the ground should prescribe. Most people can afford generic paracetamol or ibuprofen. Taking up an appointment to get these cheap medications is why the patients with a real need to be seen for our expertise can’t be seen. Each prescription for calpol costs about £60 if you include what it would cost to be seen by a professional and prescribe something readily and cheaply available.