Prescribing restrictions might lead to inequalities if patients cannot afford over-the-counter (OTC) medicines, the Royal Pharmaceutical Society (RPS) has warned.

NHS Clinical Commissioners (NHSCC) and NHS England have launched a consultation document on reducing prescribing OTC medicines.

The consultation concerns items for 35 minor and short-term health conditions that don’t need treatment.

But RPS chair Sandra Gidley said that ‘all pharmacists support self care for minor self-limiting conditions and would encourage people to purchase treatments when they are able - and there's the crunch’.

She continued: ‘One of the consequences of implementing a reduction in prescribing would be to exacerbate health inequalities amongst those on already stretched incomes.'

‘This group are more likely to experience poor health but could end up with less access to treatment as a result of this proposal.

'Shouldn't be implemented'

Ms Gidley continued: ‘This move also fundamentally alters the principle that care is free at the point of delivery and as such should be legislated for by Parliament and not implemented by Clinical Commissioning Groups.’

But the NHSCC has created provision to 'address these concerns', it said.

Its chief executive Julie Wood told The Pharmacist that during the pre-consultation phase of the proposals, they 'heard concerns from a number of organisations and individuals about the potential impact of the proposed guidance on health inequalities'.

She said: 'That is why we have included an exception clause for patients where the clinician considers the ability to self-manage is compromised as a consequence of social, medical or mental health vulnerability to the extent that their health and/or wellbeing could be adversely affected if left to self-care.'

Saving money

Data from the NHS Business Services Authority (NHSBSA) shows that in the year prior to June 2017, the NHS spent around £569m on prescriptions for medicines for minor conditions.

NHS Clinical Commissioners and NHS England found that restricting prescriptions could save up to £136m.

The guidance argues that these resources ‘can be used for other higher priority areas that have a greater impact for patients, support improvements in services and deliver transformation that will ensure the long-term sustainability of the NHS’.

It said: ‘The costs to the NHS for many of the items used to treat minor conditions are often higher than the prices for which they can be purchased over the counter as there are hidden costs.

‘For example, a pack of 12 anti-sickness tablets can be purchased for £2.182 from a pharmacy whereas the cost to the NHS is over £3.003 after including dispensing fees.

‘The actual total cost for the NHS is over £35 when you include GP consultation and other administration costs.’

The consultation closes on 14 March 2018.