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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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a pharmacy otc imageOctober 24 2017

The government should further empower the public to self-care before preventing over the counter medicines from being prescribed by GPs, a trade body has said.

“It is vital to promote and empower more people to self care, rather than use GP and A&E services for conditions which could be self-treated at home or with advice from a pharmacist,” says the Proprietary Association of Great Britain. Taking a system-wide approach to self care could release greater efficiency savings greater than £2 billion which would be more than savings suggested in proposals to restrict what can be prescribed on an NHS prescription those outlined in the consultation document.

PAGB has made the comments on behalf of branded over-the-counter medicines and consumer healthcare manufacturers, in its response to the NHS England and NHS Clinical Commissioners consultation ‘Items which should not routinely be prescribed in primary care’. Running over the summer, the consultation sought views on allowing clinical commissioning groups to limit prescribing of certain medicines or healthcare products on the NHS.

In its response, PAGB says: “A national strategy for self care is required to provide the leadership and policy coordination to implement a range of measures to better equip people to self care. If prescribing restrictions are introduced, the implementation should be timed to first allow other self care initiatives to be embedded first.”

These initiatives could include:

  • policies to make it easier for people to buy OTC products, such as by reducing the VAT rate and increasing the number of medicine reclassifications;
  • offering GPs ‘recommendation pads’ so they can recommend rather than prescribe OTC medicines;
  • tools to empower pharmacists to support self care;
  • action to improve health literacy and steps to support people to live healthier lives;
  • the management of minor ailments.

PAGB also says that safety and efficacy should not be an assessment criteria for prescribing restrictions. “OTC medicines on the market in the UK have demonstrated clear evidence of a good safety profile, efficacy to treat the condition it is indicated for and suitability for self care. Any concerns about the safety of medicines should be addressed through existing MHRA regulatory processes.”

The Pharmaceutical Services Negotiating Committee has also published its response to the consultation. It supports in principle a proposal that 18 specific medicines should no longer be routinely prescribed in primary care, either because they are clinically ineffective, unsafe or not cost effective; or because the NHS can offer a clinically-proven alternative for patients.

However, it warns there is a “need for the development of clear communication materials for use at both local and national level so consistent messages are used by all healthcare professionals.” It would also like consideration to be given to adding these products to the NHS prescribing ‘Blacklist’ (Part XVIIIA of the Drug Tariff) to “provide greater clarity” for both community pharmacy teams and prescribers.

PSNC has also recommended that NHS England and NHSCC consider how a nationally-commissioned pharmacy minor ailments advice service would benefit both patients and the NHS, while avoiding the “unintended consequences of implementing a blanket restriction on prescribing OTC medicines for some of the most vulnerable groups within society”.

Links:
PSNC statement             
PSNC response in full     
PAGB statement                
PAGB response in full      

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