NHS England plans cull of ‘low-value’ prescriptions

"Low-value" prescriptions such as sun cream and gluten-free foods may soon no longer be available on the National Health Service in England, after NHS England announced a review into whether they should continue to be funded by the health service.

The move follows "extensive work" by NHS Clinical Commissioners which identified significant areas where potential savings of up to £400 million per year could be made through the removal of products for which NHS prescriptions are deemed inappropriate.

NHS England said its review will "seek to address the growing concern over the justification for many low value prescriptions which absorb millions of NHS funding every year, that could be spent on care which has a bigger impact on improving outcomes for patients".

The organisation will now work with clinicians and clinical commissioning groups to develop guidelines initially around a set of 10 medicines considered ineffective, unnecessary, inappropriate for prescription on the NHS, or indeed unsafe, and that together cost the NHS £128 million per year.

Further work will then look at other medicines which are of relatively low clinical value or priority or are readily available ‘over the counter’ and in some instances, at far lower cost, such as treatment for coughs and colds, antihistamines, indigestion and heartburn medication and suncream, given the financial difficulties being experienced by the health service.

"The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes," an NHS spokesman said.

"We are in agreement with NHS England that products with low or no clinical evidence of effectiveness should be reviewed with urgency," said RPS England Chair Sandra Gidley. "We are surprised that homeopathy which has no scientific evidence of effectiveness is not on the list for review. We would also agree that procurement of medicines and other products should be reviewed to try and reduce the costs of medicines to the NHS."

However, she also voiced concern over how a blanket ban of products to treat life-long conditions such as coeliac disease and chronic pain "could have unintended consequences on those who rely on these treatments to both improve the quality of life.

"In the case of coeliac disease, untreated and undertreated cases can lead to illness, and have been associated with the development of other serious conditions. For those on low incomes ability to pay for products and medicines can be a significant barrier to accessing treatment."