Proposals to restrict prescribing of over-the-counter (OTC) medicines for 33 minor, short-term health concerns could discriminate against those with long-term conditions, multimorbidities and cancer, as well as targeting young people, older people and the poorest in society, the Royal Pharmaceutical Society (RPS) in England has said.
The Society’s concern was voiced in its response to NHS England’s consultation, ‘Conditions for which over-the-counter items should not routinely be prescribed in primary care: a consultation on guidance for CCGs’. The draft guidance proposes a reduction in prescriptions for self-limiting conditions, including cold sores and infant colic, and for minor conditions that respond well to self-care and OTC treatments — for example, head lice, mild–to–moderate hay fever and adult diarrhoea. The society said it was “strongly opposed” to making OTC products for these conditions unavailable via the NHS. Such a move would “fundamentally alter the principle that care is free at the point of delivery”.
The Society further highlighted the draft guideline’s use of the term “mild” to prefix several conditions on the “minor conditions” list, saying that “there are risks to using this term as it is open to interpretation.”
The RPS recognised that some people visit GPs in order to obtain a free prescription for an item that could be purchased, and that this places added pressure on general practice. To address this, it said, primary care pharmacists could be greater utilised to support patients who are unable to purchase OTC products.
The RPS also recommended that, where possible, GPs refer patients with minor ailments to their local pharmacy, adding that the Society continues to advocate for a nationally commissioned NHS minor ailments service. It added that there was concern about the potential impact of the guidance on locally commissioned, pharmacy-based minor ailment schemes.
Rather than making OTC medicines unavailable via the NHS, the Society concluded, emphasis would be better placed on education about self care and the benefit this can have for both the patient and the health service.
The consultation closed on 14 March 2018.