Guidance for CCGs on prescription for conditions that over the counter items treat

NHS England  | April 2018 | Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs 

New guidance from NHS England for Clinical Commissioning Groups (CCGs ) to take the proposed conditions for which over the counter items (OTC)  should not routinely be prescribed in primary care guidance into account in formulating local polices, and for prescribers to reflect local policies in their prescribing practice. Spending on OTC items for the year up to June 2017 was  approximately £569 million on prescriptions for medicines, which could otherwise be purchased over the counter from a pharmacy and/or other outlets such as petrol stations or supermarkets.drug-icon-2316244_1280
These prescriptions include items for a condition:

  • That is considered to be self-limiting and so does not need treatment as it will heal or be cured of its own accord;
  •  Which lends itself to self-care i.e. the person suffering does not normally need to seek medical advice and can manage the condition by purchasing OTC items directly.
    These prescriptions also include other common items:
  •  That can be purchased over the counter, sometimes at a lower cost than that which would be incurred by the NHS;
  •  For which there is little evidence of clinical effectiveness.

NHS England gives the example that for every  £1 million saved on prescriptions for OTC items could fund :

39 more community nurses; or

  •  270 more hip replacements; or
  •  66 more drug treatment courses for breast cancer; or
  •  1000 more drug treatment courses for Alzheimer’s; or
  • 1040 more cataract operations

The full guidance can be read at NHS England 

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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

Public consultation: wasteful and ineffective drug prescriptions

A formal public consultation is being launched on new national guidelines which state that 18 treatments – including homeopathy and herbal treatments – which together cost taxpayers £141 million a year should generally not be prescribed | NHS England

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Simon Stevens, NHS England’s chief executive, described homeopathy as “at best a placebo and a misuse of scarce NHS funds”.

In addition the consultation also covers a further 3,200 prescription items, many of which are readily available and sold ‘over the counter’ in pharmacies, supermarkets, petrol stations, corner shops and other retailers, often at a significantly lower price than the cost to the NHS.

The consultation proposes initial action to limit prescribing of products for minor self-limiting conditions which currently cost taxpayers £50-100 million a year. The products include cough mixture and cold treatments, eye drops, laxatives and sun cream lotions.

NHS England is also supportive of restricting the availability of gluten-free foods on prescription, which costs £26million a year, which is currently subject to a Department of Health consultation.

Reducing antibiotic prescribing for children presenting to primary care with acute respiratory tract infection

Blair, P.S. et al. (2017) BMJ Open. 7:e014506

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Objective: To investigate recruitment and retention, data collection methods and the acceptability of a ‘within-consultation’ complex intervention designed to reduce antibiotic prescribing.

Conclusion: Differential recruitment may explain the paradoxical antibiotic prescribing rates. Future cluster level studies should consider designs which remove the need for individual consent postrandomisation and embed the intervention within electronic primary care records.

Read the full article here

Physical activity on prescription schemes (PARS)

Arsenijevic, J. & Groot, W. (2017) 

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Background: Physical activity on prescription schemes (PARS) are health promotion programmes that have been implemented in various countries. The aim of this study was to outline the differences in the design of PARS in different countries. This study also explored the differences in the adherence rate to PARS and the self-reported level of physical activity between PARS users in different countries.

Conclusions: The effects of PARS on adherence and self-reported physical activity were influenced by programme characteristics and also by the design of the study. Future studies on the effectiveness of PARS should use a prospective longitudinal design and combine quantitative and qualitative data. Furthermore, future evaluation studies should distinguish between evaluating the adherence rate and the self-reported physical activity among participants with different chronic diseases.

Read the full article here

NHS England launches national programme to combat antibiotic overusage

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Image source: Global Panorama

NHS England has today launched the world’s largest healthcare incentive scheme for hospitals, family doctors and other health service providers to prevent the growing problem of antibiotic resistance.

Launched against the backdrop of the International Patient Safety Conference taking place at Lancaster House in London today, funding will be made available to hospitals and other providers that reduce the inappropriate use of antibiotics.

Antibiotic resistance is one of the most significant threats to patients’ safety worldwide and is driven by overusing antibiotics and prescribing them inappropriately. Infections with antibiotic-resistant bacteria increase levels of disease and death, as well as the length of time people stay in hospitals. As resistance in bacteria grows, it will become more difficult to treat infection, and this affects patient care.

The NHS’ new programme, which goes live in April 2016, will offer hospitals incentive funding worth up to £150 million to support expert pharmacists and clinicians review and reduce inappropriate prescribing. In addition, a typical local Clinical Commissioning Group with a population of 300,000 people could receive up to £150,000 a year to support GP practices improve their antimicrobial prescribing.

Read the full news story here