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Powered by Guardian.co.ukThis article titled “NHS draws up list of items to be banned from prescriptions” was written by Denis Campbell Health policy editor, for The Guardian on Monday 27th March 2017 23.59 UTC

The NHS is to stop giving patients travel vaccinations, gluten-free foods and some drugs that can be bought over the counter in an effort to rescue its ailing finances.

Simon Stevens, the chief executive of NHS England, announced the changes in an interview with the Daily Mail in which he detailed new efforts to get better value for money so that money saved could instead be spent on promising therapies that have recently been developed.


GPs will be told to not prescribe medications such as those for upset stomachs, travel sickness and haemorrhoids in a new drive to eliminate waste from the NHS’s £120bn annual budget.

Stevens said: “We’ve got to tackle some of the waste which is still in the system. The NHS is a very efficient health service but like every country’s health service there is inefficiency and waste.

“There’s £114m being spent on medicine for upset tummies, haemorrhoids, travel sickness, indigestion, [and] and that’s before you get to the £22m-plus on gluten-free that you can also now get at Morrison’s, Lidl or Tescos.

“Part of what we are trying to do is make sure that we make enough headroom to spend money on innovative new drugs by not wasting it on these kind of items.”

Next month, NHS England will start reviewing 10 items which it says are “ineffective, unnecessary [and] inappropriate for prescription on the NHS, or indeed unsafe”, which together cost the service £128m a year. The Department of Health is expected to then issue new guidance advising GPs that they are not prescribed.

They include omega 3 and fish oils; the painkiller fentanyl: lidocaine medicated plasters; a tablet used to treat high blood pressure called doxazosin MR; and a drug called tadalafil, which is used to treat erectile dysfunction, along with gluten-free foods and travel vaccines.

NHS Clinical Commissioners, which represents England’s 209 NHS clinical commissioning groups (CCGs) – the GP-led bodies which hold health budgets locally – has asked NHS England to look into whether the 10 itemsare a good use of scarce cash when the NHS is undergoing the tightest budgetary squeeze in its 69-year history.

Many other common medications could soon be added to the banned list. NHS Englandsaid: “In light of the financial challenges faced by the NHS, further work will consider other medicines which are of relatively low clinical value or priority or are readily available over the counter and in some instances, at far lower cost, such as treatment for coughs and colds, antihistamines, indigestion and heartburn medication and suncream. Guidance will support clinical commissioning groups in making decisions locally about what is prescribed on the NHS.”


NHS bosses hope the moves could ultimately save as much as £400m a year. The service is facing serious financial problems. NHS trusts in England recorded a deficit of £2.45bn last year and are expected to end this financial year almost £1bn in the red again, despite repeated warnings to get their finances in order.

An NHS spokesman said: “New guidelines will advise CCGs on the commissioning of medicines generally assessed as low priority and will provide support to clinical commissioning groups, prescribers and dispensers.

“The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes.”

Stevens’s money-saving initiative is a foretaste of a major initiative he will unveil on Friday. He will announce details of his long-awaited “delivery plan” to fulfil his pledge, first made in October 2014 in his Five Year Forward View modernisation blueprint, to radically transform how the health service works by 2020 so that it delivers better care and closes the £22bn gap which is expected to open up in its own finances by then in order to remain sustainable.

He will give the go-ahead to between six and 10 of the 44 sustainability and transformation plans (STP), one covering each part of England, which are intended to implement his ideas, which centre on moving a lot of care out of hospitals and treating patients closer to home and keeping them healthier so that they avoid expensive £400-a-night unnecessary stays in hospital.

The STP plans have proved very controversial because they could see dozens of hospitals lose key services, such as their A&E or maternity unit.

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