Proposed changes to prescribing in Croydon

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Lambeth

NHS prescriptions

in Lambeth

GreaterLondon

Borough of Lambeth

1. Introduction

We are seeking your views on our proposals to make some changes to prescribing guidance around over-the-counter medicines, malaria prevention medicines and selected travel vaccines.

Our consultation starts on 3 April and ends on 26 May 2017.

2. What is Lambeth CCG?

NHS Lambeth Clinical Commissioning Group (CCG) is a membership organisation made up of all 44 GP practices in the borough. We are responsible for buying healthcare for the 400,000 registered patients and residents of Lambeth. This includes NHS services like emergency care, hospital care, community and mental health services, and prescribing medicines.

NHS Lambeth Clinical Commissioning Group

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3. What are the proposed changes

We are proposing to no longer support the routine prescribing on the NHS of the following products:

• Self-care medication for short-term minor ailments and health supplements

• NHS Prescriptions for malaria prevention medicines for travel

• NHS Prescriptions for selected travel vaccinations.

Self-care medications

These are products that can be purchased over the counter without a prescription from a pharmacy.

For the majority of healthy people most minor illnesses can be managed with advice and self-care without the need to see a doctor. Most minor illnesses will get better with time.

If a medicine is needed to treat symptoms such as a headache, these are widely available and can be purchased over the counter from a pharmacy.

Your local community pharmacist can give you professional advice on what else you can do to care for yourself. If your problem is more serious and needs the attention of a GP, your pharmacist will advise you to see your GP instead.

Advice is also available from NHS Choices, Health Help Now at www.healthhelpnow-nhs.net and by phoning NHS 111.

We are not proposing changes to long-term treatment with over the counter medicine such as regular pain medicine for osteoarthritis or where the product isn’t available without a prescription.

Prescriptions for self-care

medications

Prescriptions for malaria prevention medicines for travel

Prescriptions for selected travel vaccinations

Proposed changes to prescribing guidance in Lambeth

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The areas this proposal covers includes:

• Analgesics (painkillers) for short-term use

• Anti-diarrhoeal medication for short term use (up to 72 hours)

• Antifungal treatment for short term minor ailments

• Antiperspirants

• Cold sore treatment

• Colic treatment

• Cough and cold remedies

• Ear wax removers

• Eye treatments/lubricating products

• Head lice treatment and scabies treatment

• Haemorrhoidal preparations for short term use (5-7 days)

• Herbal and complementary supplements

• Indigestion remedies

• Laxatives for short term use (up to 72 hours)

• Mouth wash and mouth ulcers

• Nappy rash treatment

• Hay fever medicines

• Threadworm tablets

• Topical acne treatment which is available over the counter

• Topical steroids for short term use (up to 1 week) for bites, stings or mild dermatitis

• Vitamins and minerals

• Warts and verruca treatment

Malaria prevention medicines for travel

We propose to stop prescribing malaria prevention medicines for use in travel on a NHS prescription to bring the borough in line with national guidance.

NHS patients are entitled to receive free advice about travel. GP practices will be able to issue private prescriptions that people pay for, for malaria prevention medicines and continue to offer travel advice, or patients can seek advice from private travel clinics. Antimalarial medicines are now widely available.

Selected travel vaccinations

We propose to stop offering the following vaccines for travel on the NHS to bring us in line with national guidance.

• Hepatitis B - single vaccine and Hepatitis A+B combined vaccine

• Meningitis vaccine

• Japanese B encephalitis

• Rabies vaccine

• Tick-borne encephalitis

• Yellow Fever

NHS patients are entitled to receive free advice about travel. Only some vaccinations required for travel are available on the NHS such as Hepatitis A vaccine and Typhoid vaccine in line with national guidance.

GP practices may charge a registered patient for the selected vaccinations listed above if requested for travel or the patient may be given a private prescription to obtain vaccinations, or people can seek advice from private travel clinics.

NHS Lambeth Clinical Commissioning Group

Proposed changes to prescribing in Croydon

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4. The case for change

Self-care of minor conditions Self-care is about avoiding becoming ill, treating common illnesses at home and seeking help when needed. It is also about managing any conditions you have in a way that puts you in control and improves your quality of life. If more people are able to meet their minor health needs through self-care, this will ease the pressure on health services.

The medicines covered in this proposal can be purchased from your pharmacy. The NHS recommends everyone keeps a well-stocked medicine cabinet with self-care medicines.

Freeing clinical time for those most in needIt is estimated that 50 million visits to the GP are made every year in England for minor ailments such as coughs and colds, mild eczema and athlete’s foot.

The proposals for over the counter medicines support our plans to promote self-care and the self-management of minor and self-limiting conditions, and to reduce unnecessary demand on GP time, including the out of hours services. This will free up clinician time for people who have more complex healthcare needs and who need more active support in managing their health.

National guidanceThe proposals for discontinuing malaria prevention medicines on a NHS prescription for travel have been supported by public health specialists. If taken forward, the proposals will bring our guidance back in line with national policy. Lambeth is one of only three clinical commissioning groups nationally offering malaria prevention medicines through the NHS.

Proposals to discontinue providing selected travel vaccines have been developed in consultation with public health specialists and aim to standardise local provision of the specific travel vaccines.

These proposals are part of Lambeth’s plans within the community-based care workstream of the South East London Sustainability and Transformation Plan (STP), Our Healthier South East London. Similar discussions are taking place in each borough within south east London, as well as in many other areas of the country.

The cost of medicinesThe primary care prescribing budget for Lambeth is around £35 million for this year.

Taken together, these proposals will support us to contain the costs of medicines on the local NHS budget, and will potentially contribute cost savings of £1 million per annum to the NHS in Lambeth.

Proposed changes to prescribing guidance in Lambeth

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5. How we spend NHS money in Lambeth

We have £520 million in the financial year 2017-18 to spend on local healthcare for the Borough of Lambeth.

This equates to around £1,300 per person.

Prescribing for local people is 7% of our budget.

NHS Lambeth Clinical Commissioning Group

Acute £286.3m

Mental health £73.1m

Other £7.7m

Community care

£34.4m

Primary care prescribing

£35.8m

Primary care £62.2m

Continuing care

£20.3m

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6. Have your say

We are gathering views from patients, clinical staff and wider stakeholders. We will use these views to inform our decision.

We are keen to hear from you if you live in Lambeth, especially if our proposals might affect you.

We would like to know:

• How much you agree or disagree with our proposals to:

o encourage people to use over the counter products to treat acute minor illnesses and conditions that get better with time, rather than to provide them on NHS prescription

o stop offering malaria prevention medicines on NHS prescription

o stop offering other selected travel vaccinations on NHS prescription.

• Any specific concerns you have about our proposals.

• How we could reduce any possible negative impacts of these proposals on any groups of people in Lambeth.

• How we should communicate with Lambeth people about our decision and our plans.

You can give your views by:

• Filling in our short survey available via our website www.lambethccg.nhs.uk

• Emailing us at lamccg.pharmacyviews@nhs.net

• Writing to us at Prescribing Views, NHS Lambeth CCG, 1 Lower Marsh, London SE1 7NT

• Visit our stall at the Our Healthier South East London event in May. Details will be available on our website.

• Attending a Patient Participation Group meeting at your GP practice – ask at reception when the next one is

• Inviting us to come and speak to members of your local group

• Phoning us on 0203 049 5749

The closing date for views is 26 May 2016 at 5pm.

When will we decide? After consultation closes on 26 May we will consider fully all the views we have heard. We expect to reach a decision about our proposals on 5 July 2017 at a meeting of our Governing Body. This meeting takes place in public and you are welcome to attend to hear our discussions.

We have a Public Forum before each Governing Body meeting, where any member of the public can ask questions. You can find details of our meetings on the NHS Lambeth CCG website at www.lambethccg.nhs.uk

April 2017

Proposed changes to prescribing guidance in Lambeth