GPs asked for opinions on restricting OTC prescribing

NHS England has launched a consultation on proposals to restrict prescribing of some over-the-counter (OTC) products, which it predicts could free up NHS funds to the value of £136m.

In the year prior to June 2017, the NHS spent approximately £569m on prescriptions for minor conditions which could otherwise be purchased over the counter from a pharmacy and/or other outlets. | GEOFF TOMPKINSON/SCIENCE PHOTO LIBRARY
In the year prior to June 2017, the NHS spent approximately £569m on prescriptions for minor conditions which could otherwise be purchased over the counter from a pharmacy and/or other outlets. | GEOFF TOMPKINSON/SCIENCE PHOTO LIBRARY

NHS England states that by ending routine prescribing for minor, short-term conditions, many of which are self-limiting or cause no long-term effect to health, funds could be diverted to other areas, allowing it to expand other treatments for major conditions such as cancer and mental health problems.

Affected OTC products

The proposals include stopping the routine prescribing of products that:

  • Have low clinical value and where there is a lack of robust evidence for clinical effectiveness, such as probiotics, vitamins and minerals.
  • Treat a condition that is considered to be self-limiting (eg, sore throat or coughs and colds)
  • Treat a condition that could be managed by self-care, ie, where the person does not need to seek medical care or could visit a pharmacist (eg, indigestion, mouth ulcers and dry eye)

Overall, the proposals cover eight self-limiting conditions and 25 minor ailments deemed suitable for self-care (see table below). NHS England says that the consultation does not affect the prescribing of items for longer term or more complex conditions or where minor illnesses are symptomatic or a side effect of something more serious.

Current spending

As an example of the potential savings to be made, NHS England states that each year it spends £4.5m on dandruff shampoos, £7.5m on indigestion and heartburn, and £5.5m on mouth ulcers. Implementing self-care for these three conditions alone would result in a total annual saving of £17.5m.

The consultation is open for comments until March 14, 2018. 

Conditions covered by the consultation
  • Acute sore throat
  • Cold sores
  • Conjunctivitis
  • Coughs, colds and nasal congestion
  • Cradle cap (seborrhoeic dermatitis – infants)
  • Haemorrhoids
  • Infant colic
  • Mild cystitis
  • Contact dermatitis
  • Dandruff
  • Diarrhoea in adults
  • Dry eyes/sore tired eyes
  • Earwax
  • Excessive sweating (hyperhidrosis)
  • Head lice
  • Indigestion and heartburn
  • Infrequent constipation
  • Infrequent migraine
  • Insect bites and stings
  • Mild acne
  • Mild dry skin/sunburn
  • Mild to moderate hayfever/seasonal rhinitis
  • Minor burns and scalds
  • Minor conditions associated with pain, discomfort and fever
  • Mouth ulcers
  • Nappy rash
  • Oral thrush
  • Prevention of dental caries
  • Ringworm/athlete's foot
  • Teething/mild toothache
  • Threadworms
  • Travel sickness
  • Warts and verrucae
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