An NHS group in Harrogate says it could stop prescriptions for over-the-counter medicines to help it deal with an £8.4m budget deficit.

Harrogate and Rural District Clinical Commissioning Group (CCG) said it was facing a “growing demand” on services.

The CCG said doctors last year prescribed more than three million items at a cost of £25m.

Prescriptions for the painkiller paracetamol accounted for £260,000.

The CCG said it was consulting local people to “to help identify where demand can be reduced and costs curtailed”.

‘Difficult choices’

The group said that it had seen a 2.7% rise in the number of Accident and Emergency admissions between April and June this year, compared with the same period last year, at an additional cost of £125,000.

Rick Sweeney, governing body member at the CCG, said the group was reviewing all parts of the service, including outpatient appointments and surgery.

“The challenge for the CCG is to spend the financial allocation differently, ” he said.

“As an organisation we have a number of difficult choices to make about what is affordable for the whole of our local population against an ever increasing demand for access to health services.”

Respondents to the GP magazine poll suggested that prescription charge exemptions need reviewing. They also called for a wider role for pharmacists giving OTC medicines to patients who are exempt from prescription charges.

In total, 68% of GPs responded ‘yes’ to the question ‘Should the NHS stop providing free prescriptions for medicines available over the counter?’.

 

Many GPs responding to the poll said the NHS should not have to fund the appointments and staff time needed to make OTC drugs available at NHS expense.

‘I am sick of prescribing paracetamol, which is so cheap,’ one said. ‘The people who ask for it are not the most needy.’

One GP said the current policy was ‘madness’: ‘We have many patients attending a £15 appointment to get a scrip for £1 of medication.’

Another said that eliminating free prescriptions for drugs available OTC would help ‘avoid unnecessary congestion in surgeries’.

GPs also argued that ‘medicine cupboard’ items should be regarded as a basic household expense.

‘It should be part of a parent’s responsibility for having children to keep Calpol or Nurofen in the house and not depend on a prescription for this,’ one respondent said.

But other GPs warned that restricting NHS funding for OTC medicines would discriminate against people on low incomes.

‘OTC medicines are beyond the means of some people,’ one GP said.

Concerns were also raised that limiting access to paracetamol on the NHS would lead to patients demanding stronger medicines only available on prescription.

To restrict prescribing of some licensed drugs at NHS expense, the DH would need to add these drugs to the blacklist of ‘drugs, medicines and services not to be ordered under a GMS contract’.

This ‘blacklist’ is set out in the GMS contract and in Part XVIIIA of the Drug Tariff, but has not been updated since it was compiled in 1985. It includes products that are now unavailable and, of those that are still available, most are branded OTC treatments for minor ailments.

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