Jonathan Burton, chair of the Royal Pharmaceutical Society’s (RPS’s) Scottish Pharmacy Board (SPB), has told members of the Scottish Parliament that it would be “ridiculous” if decisions on which medicines NHS practitioners are allowed to prescribe were based on their availability over the counter.
Burton was responding to a question posed by Emma Harper, Scottish National Party member for South Scotland, during a meeting of the Parliament’s Health and Sport Committee on 28 January 2020. The committee is carrying out an inquiry into the supply of and demand for medicines in Scotland.
In the meeting, Harper referred to guidance introduced by NHS England in 2018, which limits the prescribing of certain medicines for minor self-limiting conditions if those medicines can be bought over the counter, and asked if Scotland should follow suit.
Drawing on his own experience of supplying emollient products to patients with skin conditions, Burton told the meeting that a product not being prescription-only “does not diminish its value or the importance of having adequate support and adequate supplies of that medicine for the patient, because they are probably going to need quite a lot of it”.
Earlier in the meeting, Harper said she would be “a bit uncomfortable about making mandatory rules to say that someone cannot have a particular prescription and they have to buy it at the pharmacy instead”.
Burton went on to emphasise that self-care was to be encouraged and that he advised patients to keep medicines like paracetamol, ibuprofen and some indigestion remedies at home for that purpose.
However, he added: “It is our responsibility to make sure that [unwell patients] get advice, and sometimes the medication, that they need.
“The legal classification of that medicine should not really come into it.”
Burton’s views were echoed by Matt Barclay, director of operations at Community Pharmacy Scotland, who said that he “would be reluctant for any clinician to receive a diktat saying that patients cannot have a particular prescription”.
“I know that Emma Harper is not suggesting that. Giving the clinician the freedom to make the clinical decision that is in the best interests of the patient in front of them is always the right thing.”
When NHS England launched the guidance in March 2018, it said that limiting prescriptions for certain conditions would save almost £100m each year.
However, at the time Sandra Gidley, then chair of the Engligh Pharmacy Board and now president of the RPS, said that the Society was ”concerned that the implementation might disadvantage patients on low incomes and people may be denied treatment because of their inability to pay”.