Changes to prescribing of OTC products for self-limiting conditions. This affects ALL Community Pharmacies and their patients and customers.
You may recall that NHSE published guidance about moving treatment of minor, self-limiting conditions with OTC products away from prescription and encouraging the public to purchase these remedies. CCGs around the country are being asked to implement this policy.
This change is linked to the NHS needing to save money and is seen as a way in which the public can be encouraged to purchase simple medicines and money saved by the NHS could be used to treat more serious conditions. The guidance considered those who are entitled to free prescriptions, but it was decided that being in receipt of free prescriptions (even on income grounds) was not considered a barrier to asking people to purchase simple, usually quite cheap medication.
It is recognised that this policy will require a change in patient behaviour and the CCGs across Staffordshire are raising public awareness and encouraging purchasing over the counter medicines by running an information campaign (starting in July 2019).
The campaign aim is to raise public awareness of the benefits of using their local pharmacy. This promotes the role of the local pharmacy as the first port of call to treat their minor ailments and purchase first aid medicines to treat their family.
The focus of the public campaign is that patients can see a pharmacist without an appointment so they can get the help they need for self-limiting conditions much more quickly than if they try to see the GP.
Pharmacies are asked to support this NHS initiative by:
• Encouraging the public to purchase OTC medicines to treat their minor ailments
• Reinforcing the message - GPs will not be prescribing OTC medicines for minor ailments
• Not referring “levy-exempt” patients to GPs for “free” prescription
• Displaying the Self-Care 2019/20 poster in a prominent area of the Pharmacy.
• Actioning any referrals from GP practices regarding the treatment of common ailments. Please help the patient to purchase an appropriate product (GPs have a supply of referral pads so they can give the patient some information to take to the pharmacy).
• Using the Pharmacy referrals pad to signpost patients back to their GP for a prescription ONLY where appropriate (eg if the product license for an OTC product would not cover the patient’s condition)
The CCGs will be providing every Community Pharmacy in Staffordshire with a sample section of the materials however if you would like more information or materials please contact Claire Dearden on 01785 854116 or firstname.lastname@example.org
What does this mean for Pharmacy First Common Ailments Service?
NHSE locally commission the Common Ailments Service, however, in light of the national guidance they feel they are no longer able to continue this service. In Staffordshire the Common Ailments Service will continue until 31.8.2019
You are still able to supply under this Common Ailments service until the end of August but you will need to be having conversations with patients explaining the NHS drive towards patients purchasing their OTC medication. You can explain that you can help them today, but that this service is ending so you will not be able to supply items free of charge going forward.
To reiterate, GPs are also being asked not to prescribe OTC medicines so please DO NOT refer patients to the GP to ask for a prescription just because they are exempt from prescription charges – this is not helpful to patients as they are very likely to be refused a prescription (it is also not good for your relationship with your GP practice as inappropriate referrals will waste everyone’s time!).
Once the Common Ailments service has ended, please only refer patients to their GP for one of the self-limiting conditions if the product licence of the OTC product does not allow it to be used for that patient. Otherwise explain to the patient that their GP is very unlikely to write a prescription for the condition.
Conditions not Medicines: be aware of the list of conditions, the guidance is a list of conditions suitable for self-care, it is not a black list of medication, so for example the patient would be asked to purchase paracetamol for short term pain or fever but can still have it prescribed for long term conditions such as osteoarthritis.
Does this affect other Pharmacy First Services?
The UTI, Impetigo and Emergency Supply Services will continue in their current form.
Those pharmacies offering the ENT, Eye and Skin service will no longer be able to supply OTC products under the common ailments service, the patients will need to purchase OTC items which are not covered by the service PGDs.