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NHS England consultation on limiting prescribing

You may be aware that NHS England is currently consulting on plans to limit GP prescribing:
https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed/

This national consultation comes in the wake of similar exercises being carried out by a number of CCGs across the country, including Sandwell and West Birmingham.

The principles to reduce wasteful prescribing costs, to minimise avoidable GP workload and to encourage self- care are laudable and there are many suggestions in the consultation document which are eminently sensible. However there is grave concern that this initiative will inevitably put unfair pressure on GPs to limit the prescribing of some medications available over the counter and from which their patients may clearly benefit.

We would remind you that GP contractual regulations oblige the prescribing on FP10 of medications meeting the needs of their patient regardless of whether they are available OTC and regardless of the condition being “ minor” or “ self- limiting”. GP’s professional judgment must hold primacy over any NHS England or local CCG policies. There will be particular issues for practices when prescribing for patients entitled to free prescriptions ( and over 90% of prescription items are now issued free of charge).

The BMA GPC’s policy , which the LMC would fully support is that limiting prescribing as outlined in these proposals must only take place by means of the DH changing the GPC contractual obligations to remove the explicit requirement to prescribe drugs available OTC , to put in place other mechanisms (eg voucher schemes, universal minor ailment schemes ) to enable treatments to remain free on the NHS for certain groups of patients and to expand the “ blacklist “ of treatments which are unavailable on NHS prescription. It is the job of the government to ensure this happens properly, rather than putting GPs in an invidious position , risking being in breach of their contracts and patient complaints, by making them responsible for rationing decisions which the government should be taking.

We would urge you all to read the consultation document and to respond to it.

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