Reducing prescriptions for over-the counter medicines

NHS England is launching a public consultation on reducing prescribing of over-the-counter medicines for 33 minor, short-term health concerns.

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These prescriptions include items for a condition:

  • That is considered to be self-limiting and so does not need treatment as it will heal of its own accord;
  • Which lends itself to self-care, i.e. that the person suffering does not normally need to seek medical care but may decide to seek help with symptom relief from a local pharmacy and use an over the counter medicine.

Vitamins/minerals and probiotics have also been included in the consultation proposals as items of low clinical effectiveness which are of high cost to the NHS.

NHS England has partnered with NHS Clinical Commissioners to carry out the consultation after CCGs asked for a nationally co-ordinated approach to the development of commissioning guidance in this area to ensure consistency and address unwarranted variation.  The intention is to produce a consistent, national framework for CCGs to use. The consultation closes on the 14 March 2018.

View the full consultation document here

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Strategic commissioning

CCGs in the UK should move towards strategic commissioning if the healthcare system is to embrace a move toward integrated local care, claims a new briefing from NHS Clinical Commissioners (NHSCC).

The publication brings out lessons based on evidence from the UK and health systems abroad. These are drawn from the perspectives of those implementing and developing policy around the new care models and from research of international models, primarily of high performing place-based systems of care that have developed in New Zealand, Sweden, Spain and the United States.

‘Making strategic commissioning work’ puts forward a number of recommendations aimed at easing the transition to strategic commissioning models.

  • The patient must be placed at the centre with a focus on quality – targets, payment incentives and prescriptive regulation have proved largely unsuccessful in driving system improvement and ensuring financial sustainability.
  • Clinical commissioning leadership and engagement must be retained – the evidence shows that success of population level planning is reliant on the engagement of clinicians in primary, secondary and community care, as well as the wider workforce.
  • National clarity on the ‘end state’ is essential – while local areas must lead the development of models for integrated health and care delivery, internationally, no system has been implemented without clear political consensus and a legislative framework to support it on an ongoing basis. In the UK, this could mean a national framework is needed – provided this is not too prescriptive to limit local development.

Full document: Making strategic commissioning work: Lessons from home and away

Guidance for CCGs on items not to be routinely prescribed

NHS England has published Items which should not routinely be prescribed in primary care: guidance for CCGs.

This guidance is addressed to CCGs to support them to fulfil their duties around appropriate use of prescribing resources supporting CCGs in their decision-making, to address unwarranted variation, and to provide clear national advice to make local prescribing practices more effective.

Additional link: NHS Clinical Commissioners press release