NHS England plans for new over-the-counter medicines restrictions for minor illness could place GPs ‘in breach of contract’, the BMA has warned.
NHS England proposed in a consultation launched in December that GPs should stop prescribing over-the-counter medicines for over 30 minor, short-term health concerns.
But in its official response, the BMA argues that if a GP were ‘to refuse to issue an FP10 for treatment that they had recommended they would clearly be in breach’ of the GMS contract and ‘open to complaint and possible financial redress’.
The BMA points in particular to paragraph 14.2.2 of the contract which states that ‘a prescriber shall order any drugs, medicines or appliances which are needed for the treatment of any patient who is receiving treatment under the contract’.
It adds that under the new proposals GPs will be forced into ‘the unacceptable position of having to make value-judgements about the likelihood of patients being able to access the required medication’ if a prescription isn’t given.
The 33 conditions listed in the final version of NHS England’s proposals include cough and colds, infant colic, mild migraine, malaria prevention and haemorrhoids. The consultation will also look at the prescribing of probiotics and vitamins and minerals.
The BMA’s submission further disagrees with the classification of several of the illnesses in NHS England’s consultation, including indigestion and dry eyes, which it argues ae long-term issues.
The BMA adds that the proposals are ‘particularly problematic’ for patients with long-term conditions living in rural areas or with mobility issues, as ‘the pack sizes of NSAIDs and paracetamol available without prescription are too small to allow for long term use’.
The BMA also warns that older patients and those with disabilities will be ‘disproportionately affected’ by the proposals, in violation of the Equality Act 2010.
It concludes that the changes proposed are ‘too important’ to be managed at a CCG level ‘after local consultation, even if that consultation is nationally co-ordinated’.
The response said: ‘The right of patients to receive treatment free at the point of delivery (but subject to specific charges as defined in regulation) is a fundamental principle of the NHS, and if this is to be changed it should be done so by legislation on a national basis by those elected to represent the population and answerable to them for their actions.
‘This is too important a change from established practice to happen on a local basis after local consultation, even if that consultation is nationally co-ordinated.’
BMA submitted a similar warning to NHS England’s consultation on restricting the prescribing of 18 over-the-counter and ‘low value’ items last year, arguing that plans were ‘unworkable’ and ‘totally unacceptable’.