Bury’s policy in relation to prescribing over the counter items for minor, short term conditions will be updated to include 11 additional conditions for which over the counter items should not routinely be prescribed.

The decision, made at NHS Bury Clinical Commissioning Group’s (CCG) Governing Body meeting this month, takes into account new Greater Manchester guidance to reduce the prescribing of over the counter items for a range of minor, short term health conditions, along with feedback from a four week period of engagement on the proposals.

Following the publication of the new Greater Manchester guidance, NHS Bury CCG had the opportunity to review its current Prescribing for Clinical Need Policy.  Bury’s Prescribing for Clinical Need Policy which has been in place since 2015, includes a wide range of conditions for which over the counter items for minor conditions are not routinely prescribed by Bury GPs.  The aim is to ensure that NHS monies are not routinely spent on items where the condition will clear up of its own accord, for minor illnesses considered suitable for self-care that could be treated with items purchased from a pharmacy or other outlet and those items for which there is limited evidence of clinical effectiveness, such as vitamins, minerals and probiotics.

The period of engagement sought views on proposals to:

  • Retain the conditions currently included in Bury’s Prescribing for Clinical Need Policy, including two conditions that are not included in the new Greater Manchester guidance (scabies and vaginal thrush).
  • Updating Bury’s Prescribing for Clinical Need Policy to align to the new Greater Manchester guidance in relation to an additional 11 conditions for which over the counter items should not routinely be prescribed*.

262 individuals provided their feedback on the proposals through a survey.  From the feedback received, there was a good amount of support to encourage self-care and to ensure that NHS monies are only spent on items that are safe, clinically effective and provide a clear health benefit, to free up resources to be spent elsewhere to improve health in Bury.

Despite not being included in the new Greater Manchester guidance, and some concerns including in relation to affordability, the majority of respondents agreed with the intention to retain scabies and vaginal thrush in Bury’s Prescribing for Clinical Need Policy as conditions for which over the counter items should not routinely be prescribed.

In relation to the 11 additional conditions included in the new Greater Manchester guidance that are not currently included in Bury’s Prescribing for Clinical Need Policy, there was support to include these conditions in the policy, however, there were also concerns about affordability, self-diagnosis and potential complications if conditions aren’t treated appropriately.

An important part of the period of engagement was to offer the opportunity for people to highlight if they felt the CCG had failed to consider something significant, before coming to a decision.

Dr. Jeffrey Schryer, Chair of NHS Bury CCG and local GP said: “We are grateful to everyone that shared their views through this period of engagement, ensuring that local issues were understood and considered before a decision was made.

“We have a duty to ensure that our resources are used wisely, and this includes not routinely spending on items where a condition is self-limiting and will get better on its own, where the condition is suitable for self-care or where there is little evidence that the medicine works.  Having considered the feedback received, whilst we understand there were some concerns, no significant areas emerged that the CCG had not already considered.

“Whilst a range of over the counter items for minor conditions are not routinely prescribed by local GPs, if it is felt there are exceptional circumstances, the decision will always remain with the prescribing clinician.”

ENDS

Date: 29th May 2019

Notes to editor:

* The additional 11 conditions included in the new Greater Manchester guidance that are not currently included in Bury’s Prescribing for Clinical Need Policy are:

  • Haemorrhoids (piles)
  • Mild cystitis
  • Contact dermatitis (a type of eczema)
  • Hyperhidrosis (excessive sweating)
  • Infrequent constipation
  • Infrequent migraine
  • Minor burns and scalds
  • Oral thrush
  • Ringworm
  • Travel sickness
  • Fungal nail infection