NHS Prescriptions for medications available to purchase over the counter

From 31 May 2018, a range of medicines that are available to buy over the counter from pharmacies and supermarkets will no longer be routinely prescribed by GP surgeries.

These are medicines associated with a number of minor, short term conditions, which either get better by themselves or you can treat yourself. (A full list of these is below) The decision in Gloucestershire follows a recent national consultation and NHS England guidance which recommends this change (referenced below). As a commissioner (buyer) of services and treatments, we have a duty to plan and prioritise fairly and use the public money available to achieve the maximum health benefit for the people of Gloucestershire.

The annual prescribing cost for these medicines in Gloucestershire is around £2 million which we think could be put to better use to support more serious health conditions. Costs to the NHS are often higher than those over the counter when other fees are included such as those for dispensing or medical consultations.

The change will also help to ease some of the pressure on GP surgeries, so doctors and other healthcare professionals can concentrate on patients with more serious or long term conditions. The average cost of many of these medicines no longer prescribed on NHS prescription will be around £2 to £3 – for example olive oil ear drops, antifungal skin cream or antihistamine tablets. The price of these items may vary slightly, but will range from 30p (for a small packet of paracetamol) to around £5 (for a bottle of branded cough medicine). Please discuss the best range of medicines available to you with your community pharmacy team.

We hope that you understand the rationale behind this decision. If you have any concerns about how this will impact your health, please contact your GP or Practice Nurse. If you have any concerns or complaints about the decision, please contact the CCG at: glccg.pals@nhs.net.

NHS England guidance

Conditions for which prescribing should be restricted from reference above:

Items of limited clinical effectiveness
1. Probiotics
2. Vitamins and minerals

Self-limiting conditions
3. Acute sore throat (short term sore throat)
4. Cold sores of the lip (infrequent)
5. Conjunctivitis (pink eye/swelling and redness around the eye/eye infection)
6. Coughs and colds and nasal congestion
7. Cradle cap that causes distress to the infant and is not improving (yellow scaly patches that sometimes
appear on the scalps of young babies).
8. Haemorrhoids (piles)
9. Infant colic (stomach pain/trapped wind pain)

Minor conditions suitable for self-care
10. Mild cystitis (pain when you urinate due to mild infection)
11. Mild irritant contact dermatitis (mild allergic type of skin reaction)
12. Dandruff (mild scaling of the scalp without itching)
13. Diarrhoea (adults) (frequent watery bowel movements)
14. Dry eyes / sore tired eyes
15. Earwax
16. Excessive sweating (mild – moderate hyperhidrosis)
17. Head lice
18. Indigestion and heartburn
19. Infrequent constipation (difficulty in passing stools)
20. Infrequent migraines
21. Insect bites and stings
22. Mild Acne
23. Mild dry skin
24. Sunburn
25. Sun protection
26. Mild to moderate hay fever / seasonal rhinitis
27. Minor burns or scalds
28. Minor conditions associated with pain, discomfort and/fever (e.g. aches and sprains, headache, period pain,
back pain
29. Mouth ulcers
30. Nappy rash
31. Oral thrush
32. Prevention of dental caries (tooth decay)
33. Ringworm/athletes foot (types of fungal skin infection)
34. Teething/mild toothache
35. Threadworms
36. Travel sickness tablets
37. Warts and verrucae