CCGs are advising patients to spend more time in the sun and buy supplements over the counter, in order to mitigate the ‘strong impact’ Government advice on prescribing vitamin D is having on budgets.
The move comes as GP commissioners estimate the cost of supplying vitamin D supplements could escalate to as much as £20m over the next few years for their area.
The Chief Medical Officer wrote to all GPs earlier this year to urge them to prescribe vitamin D supplements in all patients at-risk of being deficient in the mineral.
But GP commissioners say they are concerned about the impact this advice will have on their resources for other programmes, and in one area they have embarked on a major public awareness campaign to urge at-risk patients to go out in the sun more.
In order to cut costs by £2m this year, a CCG in Tower Hamlets has launched a campaign to encourage all groups at risk of vitamin D deficiency to spend more time in the sun and eat vitamin D rich foods.
They have produced a leaflet and will talk with schools to ensure children are encouraged to spend more time in the sun and eat a balanced diet.
The leaflet says: ‘Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without overly raising the risk of skin cancer.’
Dr Sam Everington, chair of NHS North East London and the City, said: ‘The risk in prescribing vitamin D is that you don’t solve the underlying problem. You don’t get to the root. The issue is changing people’s lifestyle.’
‘We would much rather invest the same money in public health responses which are a more cost-effective solution.’
Leicester City CCG said they were concerned vitamin D prescribing costs ‘will have a strong impact on budgets’ and suggested that GPs should prescribe a cheaper vitamin D supplement instead.
NHS Oxfordshire also are sticking to a policy set out in 2009 that says there is ‘insufficient evidence’ to support the routine commissioning of high-dose vitamin D supplements, and that they should be a ‘low priority’.
The statement says: ‘There was a lack of evidence regarding the groups of patients who might benefit from such supplementation, and lack of evidence to demonstrate clinical effectiveness.’
But Dr Sally Hope, honorary research fellow in women’s health at the University of Oxford and a GP in Woodstock, Oxfordshire, said she was being encouraged to tell patients to buy supplements over the counter rather than prescribe them.
She said: ‘People at the highest risk of hip fracture, which is a huge expense to the NHS, are housebound- either at home or in residential care and they don’t get out, ever.’
‘Housebound patients need to be prescribed vitamin D.’