With an ever increasing demand on NHS services, the NHS at a national and local level is constantly reviewing the products, services and treatments it provides to ensure that its resources are being used efficiently to provide the best health outcomes for the population. This enables the NHS to target its resources at frontline services and people with the most urgent clinical needs.
It is in this context that the four Derbyshire Clinical Commissioning Groups (CCGs) – the organisations responsible for buying and organising the delivery of NHS services on behalf of the Derbyshire population - began to review their policies on the provision of gluten-free products and the provision of medicines and products that can be bought over the counter to treat short term, self-limiting conditions such as a cough or a cold.
As part of this work, the views of Derbyshire residents and health and social care professionals were sought and two public consultations were launched - the first was for gluten free food prescribing which took place between February 2017 and August 2017, and the second was for prescribing medicines and products to treat short term, self-limiting conditions which took place between June 2017 and September 2017.
Following the conclusion of the public consultations, detailed reports, options and recommendations were submitted to the four Governing Bodies of the CCGs for discussion and decisions at their board meetings. These took place in November and December 2017 and their individual decisions all supported the option to no longer routinely commission the prescribing of gluten free foods and to stop the prescribing of medicines and products that are available over-the-counter from pharmacies and shops such as supermarkets to treat short term, minor self-limiting conditions. These policies will apply to all Derbyshire NHS providers and contractors. The decisions taken by the Governing Bodies are supported by the Joint Area Prescribing Committee (JAPC), the body responsible for developing prescribing guidelines.
Dr Avi Bhatia, GP and Chair of Erewash Clinical Commissioning Group, speaking on behalf of the four CCGs said:
“On behalf of the four Derbyshire Clinical Commissioning Groups (CCGs) and their Governing Bodies I would like to thank everyone who took part in the two consultations. Listening to the views of our patients as well as our colleagues across health and social care is vitally important as they really help to inform our important commissioning decisions. We do not take these important decisions lightly and we know that the decisions we have taken will involve change for people who are currently receiving prescriptions for these products.”
Dr Andrew Mott, Chair of the Derbyshire Joint Area Prescribing Committee (JAPC), the body responsible for developing prescribing guidelines, said:
“It is essential that the views of our patients and public, and colleagues who prescribe are taken into account. We have been closely involved with the discussions and the public consultations from the beginning, and our views have been included throughout.”
Dr Avi Bhatia outlines the next steps for implementation:
“All patients who have received a prescription for a gluten free product in the previous six-months will receive a letter from us in due course informing them of the change in policy and will advise them of information, help and support they might find useful to help them manage a gluten-free diet.
“The adoption of the self-care policy marks the beginning of what will be a sustained campaign across Derbyshire to raise awareness of the importance of self-care. We will utilise patient notice boards and information screens in GP practices and pharmacies as well as websites, social media and other channels to share advice and support as part of our move towards helping people to self-care.
“Our commitment as clinicians is to only use the prescribing budget for medicines and products which have a clear evidence base of working for most patients. We will support patients to improve their understanding about medicines and how to look after themselves better and work with other healthcare staff to help raise awareness of self-care.”