Changes to how the NHS prescribes ‘over the counter’ medicines for minor health conditions

June 2019 update

Prescribing preparations available to buy over the counter

NHS Buckinghamshire CCG is committed to providing best value by using our resources well. To support the cost effective and evidence based use of medicines, we no longer support the routine prescribing of health supplements and medications that can be bought over the counter.

Why are we doing this?

  • We want to help people live longer, healthier lives and support them to take better care of their health
  • By managing minor health needs through self-care, it will help to ease the pressure on the NHS. Self-care is about avoiding becoming ill and seeking help when needed
  • Buckinghamshire has a set amount of money to pay for the health services that are needed and must spend that money wisely

What treatments and preparations are included?

  • Pharmacy Only (P) and General Sales Lists (GSL) treatments that can be purchased over the counter from a pharmacy with or without advice
  • GSL treatments that can be purchased from other retail outlets such as supermarkets, petrol stations, convenience and discount stores
  • Treatments used to treat a condition that is self-limiting. It does not need treatment as it will heal/resolve by itself
  • Treatments used to treat a condition which lends itself to self-care, i.e. that the person will not normally need to seek medical care and/or treatment

Examples of treatments available OTC which will no longer be routinely prescribed on the NHS in Buckinghamshire: (This list is not exhaustive).

Our list:

  • Acne treatment
  • Analgesic/pain relief treatment (short term pain, fever, headache, muscle/joint injury, infrequent migraine)
  • Anti-fungal treatment (athlete’s foot, oral and vaginal thrush, ring worm, dandruff)
  • Antiperspirant treatment (excessive sweating)
  • Antiseptic creams and treatment for minor burns and scalds
  • Camouflage creams
  • Cold sore treatment
  • Colic treatment
  • Constipation treatment
  • Cough, cold and sore throat treatment
  • Cradle cap treatment
  • Diarrhoea treatment
  • Ear wax remover
  • Emollients and bath oils for mild dry skin
  • Eye treatments/lubricating products (Conjunctivitis/ dry eyes)
  • Fluoride containing products for prevention of dental caries
  • Haemorrhoid (piles) treatment
  • Hayfever treatment
  • Head lice treatment
  • Herbal and complementary treatments
  • Homeopathic preparations
  • Indigestion and heartburn (dyspepsia) treatment
  • Mild cystitis treatment
  • Mouth ulcer treatment and treatment for teething
  • Nappy rash treatment
  • Probiotics
  • Scabies treatment
  • Sunburn treatment
  • Suncream
  • Threadworm treatment
  • Topical steroid treatment (insect bites/stings, contact dermatitis, nappy rash)
  • Travel sickness treatment
  • Vitamins and minerals
  • Wart and verruca treatment

What general exclusions apply?

  • Medicines that can only be obtained with an NHS prescription
  • Where an OTC medicine is outside of its marketing authorisation, also known as “off-label use” or “unlicensed use”. For example when it is not licensed for use during pregnancy or where age or existing medical condition restrictions apply
  • Where an OTC medicine is being prescribed for a long-term (chronic) condition e.g. regular analgesia in osteoarthritis
  • Frail or housebound patients
  • Where there are possible safeguarding concerns including, but not limited to, children, where there might be concerns that treatment might not be provided.

To help you look after yourself

  • Managing short term illnesses and minor conditions,
  • When to seek medical advice
  • What to take if you take other medications.
  • You do not need to make an appointment to see the pharmacist, and many pharmacies are open late and at the weekend
  • If your problem is more serious and needs the attention of another healthcare professional such as their GP, the pharmacist will advise you

Guidance for prescribers

General Medical Council (May 2013) guidance ‘Good practice in prescribing and managing medicines and devices’ states the following:

  • “‘Prescribing’ is used to describe many related activities, including supply of prescription only medicines, prescribing medicines, devices and dressings on the NHS and advising patients on the purchase of over the counter medicines and other remedies”
  • Clinical judgment should be used when considering whether it is acceptable or appropriate to ask patients to purchase their medication
  • The Self Care Forum has produced numerous resources that can be used by healthcare professionals to help support people to self-care

 

September 2018 update

NHS England shared information about reducing the prescribing of medicines or treatments that can be bought over the counter.

The information says that stopping the routine prescribing of these medicines will save the NHS around £100 million.

 

Our Plans in Buckinghamshire

In Buckinghamshire, we spent over £1.5 million in 2017/18 on prescriptions that could have been bought over the counter.

So, we are the reducing the amount we spend on around 35 different medicines and treatments for minor conditions and ilnesses.

These usually sort themselves out without any treatment or by treatments that can be bought over the counter.

We want to free up resources so we can spend them in other areas.

 

What does it mean for you?

We are asking you to buy the following items yourself. They can be bought quite cheaply from a pharmacy or supermarket:

  • Acne treatment
  • Analgesic/pain relief treatment (short term pain, fever, headache, muscle/joint injury)
  • Anti-fungal treatment (athlete’s foot, oral and vaginal thrush, ring worm)
  • Antiperspirant treatment (excessive sweating)
  • Cold sore treatment
  • Colic treatment
  • Constipation treatment
  • Cough, cold and sore throat treatment
  • Diarrhoea treatment
  • Ear wax remover
  • Eye treatments (Conjunctivitis/ dry eyes)
  • Haemorrhoid (piles) treatment
  • Hayfever treatment
  • Head lice treatment
  • Herbal and complementary treatments
  • Homeopathic preparations
  • Indigestion and heartburn (dyspepsia) treatment
  • Mouth ulcer treatment
  • Nappy rash treatment
  • Scabies treatment
  • Suncream
  • Threadworm treatment
  • Topical steroid treatment (insect bites/stings, contact dermatitis, nappy rash)
  • Vitamins and minerals
  • Wart and verruca treatment

 

You will still be prescribed these medicines if you:

  • Need long term treatment e.g. paracetamol for arthritis
  • When the medication cannot be sold due to the product licensing regulations e.g. steroid nasal sprays for children

 

Speak to your pharmacist for advice on treating minor problems e.g. coughs and colds, mild eczema and athlete’s foot. They will always tell you if you need to see a doctor.

Patients who need these drugs in regular quantities can continue to get them on prescription.

If you visit your GP who then recommends you buy the treatment, please remember they are following national guidance.

 

NHS choices has lots of information and advice on treating minor health problems with self-care

www.nhs.uk/live-well/healthy-body/home-remedies-for-common-conditions/

Find out more about the conditions for which over the counter medicines will no longer be prescribed at:

www.england.nhs.uk/medicines/items-which-should-not-be-routinely-prescribed/