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'Low-priority' items could go in NHS prescriptions shake-up to cut costs

Travel vaccinations, gluten-free foods and omega-3 supplements may no longer be available on the NHS under major cost-cutting plans.

NHS England will next month launch a consultation as it works to develop new national guidelines to stop GPs prescribing medicines and other items which are available over the counter for a fraction of the cost.

The guidelines for clinical commissioning groups (CCGs) will initially be developed around a set of 10 medicines deemed ineffective, unnecessary or inappropriate for the NHS.

The list includes omega-3 and fish oils, l idocaine plasters, r ubefacients, liothyronine, t adalafil (not all uses), d oxazosin MR, f entanyl, gluten-free foods and t ravel vaccines.

These are thought to cost the service £128 million per year, NHS England said.

The review, which will take into account the views of patient groups, clinicians and providers, could extend to over-the-counter medicines which can often be bought at a much lower cost without prescription.

Although not included in the current proposed list, NHS provision of items such as paracetamol, suncream, cough treatments and indigestion tablets could be included in future reviews.

The consultation comes following a request by NHS Clinical Commissioners which identified "significant areas" where savings of up to £400 million per year could be made.

Lidocaine plasters - for back or joint pain - and fentanyl - a painkiller for cancer patients - are among the 10 items under the focus of the initial consultation.

Travel vaccines protecting against typhoid, hepatitis A and cholera, and a triple jab for diptheria, polio and tetanus, will also be subject to review.

Simon Stevens, chief executive of NHS England, told the Daily Mail: " Part of what we are trying to do is make sure that we have enough headroom to spend money on the innovative new drugs by not wasting it on these kinds of items."

A spokeswoman for NHS England 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."

Mark Littlewood, director-general of the Institute of Economic Affairs, said: "Given the financial mess the NHS has found itself in for some years now, it is a wonder these low-cost household products were provided for in the first place - particularly when vital cancer drugs are being rationed.

"While this review is a step in the right direction, it does not go far enough. There will need to be significantly more radical cutbacks and a complete rethink of the system in order to achieve a financially sustainable and efficient health service."

Mr Stevens will announce the wide-ranging plans on Friday.

He is expected to issue new national guidance that will include a drive to recover the costs of treating EU citizens.

He hopes the plan will save the NHS up to £1 billion in two years.

Figures released by NHS England in April 2016 showed that multivitamins made up 1.33 million prescriptions in 2015, at a cost of more than £3.8 million.

One of the biggest spends that year was for the household brand indigestion aids Rennie and Gaviscon, with more than four million prescriptions at just over £26 million.

Other common brands included in prescriptions included items such as Vaseline, Strepsils, Benadryl and the verruca treatment, Bazuka.

The children's medicine Calpol accounted for 12,605 prescriptions at a cost of £84,997, while Benadryl made up 97,629 prescriptions at a £1.55 million spend.

Similar proposals are not being considered for national health provision in Scotland or Wales, which review treatments in different ways under devolved healthcare services.

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