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Changes to prescriptions – governing body meeting decision on 18 July 2017

A decision was taken at Richmond CCG's governing body meeting in public, that the CCG no longer supports the routine NHS prescribing of the following products:

  • Prescriptions for gluten free food
  • Prescriptions for vitamin D maintenance
  • Prescriptions for medicines which are available over the counter

These decisions were taken following an engagement exercise (Choosing Wisely for Richmond) which took place between 22 December 2016 and 3 February 2017. You can see a detailed report of the findings of the engagement exercise here.

The findings from the engagement exercise indicate that those who responded support proposed changes to prescribing guidance in Richmond. However, the strength of support varied for individual proposals and specific concerns were expressed across each of the prescribing-related proposals. 

The main areas of concern linked to the proposals are:

·        The longer term impact on both patients and local NHS services if individuals were not able to maintain the appropriate diet and supplementation.

·        To ensure vulnerable groups within Richmond's population are protected and able to continue to access the care they need.

·        Potential negative impact on health inequalities across the borough

·        The need for the CCG to lead in supporting and providing clear and accessible information to patients, public, service providers and healthcare professionals about the implementation of any of the proposals if agreed.

Prescriptions for baby milk

As part of the Choosing Wisely engagement, Richmond CCG also looked at the option of reducing prescriptions for baby milks and specialist infant formula. However, during the engagement exercise we received feedback from a number of sources about the complex nature of milk allergy. As a result, for now we will focus on developing improved guidelines and education for GPs and other healthcare professionals to advise when prescribing is suitable or not. These resources will be developed with dieticians, other healthcare professionals and stakeholders including Allergy UK and will be supported with patient information.

Dr Graham Lewis, Chair of Richmond Clinical Commissioning Group said: "I would like to thank everyone who spoke to us during the Choosing Wisely engagement exercise. The responses to the engagement were provided in a number of ways including direct written feedback from completed surveys, feedback from forums and meetings and free comment by letter and email which were collated and analysed.

"As a public body we have a responsibility to make best use of our allocated budget so the feedback we received was extremely important to us in making decisions about future prescribing guidance in the borough.

"The major concerns centred on patients and the public having insufficient information or knowledge about what actions they needed to take, the readiness of primary care to support these changes and concerns about vulnerable people. The former two concerns will be addressed by the development of guidelines and information for GPs, healthcare professionals and patients. Regarding exemptions to these changes there will be some clinically-defined groups of patients that will be outside of these recommendations."