Dr David Crichton’s blog: Have your say on prescription plans

This is a transcript of my My View column that was published in the Doncaster Star on Monday 8 January, 2018
I’m sure many Doncaster people won’t know that the NHS spends hundreds of millions of pounds every year on prescriptions for medicines for minor conditions that could be bought cheaper at a high street pharmacy.
They include items for a condition that:
·      is considered to be self limiting – which means it does not need treatment as it will heal or be cured of its own accord; or
·      lends itself to self care – the person does not normally need to seek medical advice and can manage the problem by buying over the counter medicines.
It also includes products:
·      that can sometimes be bought over the counter at a lower cost than what they would cost the NHS in terms of a prescription; or
·      for which there is little evidence of clinical effectiveness.
A good example is a pack of 12 anti-sickness tablets, which can be bought from a pharmacy for around £2.18 but which cost the NHS over £3.00 after including dispensing fees. In fact, the actual cost to the NHS is over £35 when you include the cost of the GP consultation and other administration charges.
So the NHS struggles to live within its means against a background of rising demand for services and finite resources, it makes sense to look at how the amount spent on such items can be reduced.
A three months long consultation is currently underway which is asking members of the public for their thoughts on proposed ending NHS prescriptions for 35 conditions where treatment products can easily be bought over the counter. The list of conditions includes;  earwax, insect bites and stings, mouth ulcers and travel sickness.
In the 12 months to June 2017, the NHS spent over £48 million on vitamins and minerals, for which there is a lack of robust clinical evidence that they actually do any good.  Vitamins and minerals are essential nutrients, which most people can and should get routinely from eating a healthy, varied and balanced diet. In most cases, dietary supplements are not necessary.
Similarly, the NHS spent around £4.5 million on prescribing treatments for dandruff. Dandruff is a common skin condition that isn’t contagious or harmful and can easily be treated with over the counter anti-fungal shampoos.
The potential benefits to the NHS from restricting the prescribing of such low clinical value products is immense. Every £1 million saved on prescriptions for over the counter treatments could pay for:
·      39 more community nurses; or
·      270 more hip replacements; or
·      1,040 more cataract operations; or
·      66 more drug treatment courses for breast cancer.
The consultation ends on 14 March, 2018 and I encourage Doncaster people to take part to make sure your views are taken into account. You can respond via an online web form at: https://www.engage.england.nhs.uk/consultation/over-the-counter-items-not-routinely-prescribed or by emailing: england.medicines@nhs.net

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