Gluten-free foods and fish oil supplements may no longer be available on prescription in England, following a review by NHS England that begins next month.

The review will seek to address the growing concern over the justification for many low value prescriptions which cost the NHS millions each year. A number of these items are available over-the-counter at a lower price than the cost to the NHS of prescribing them.

NHS England will work with clinicians and clinical commissioning groups to develop guidelines initially around a set of 10 medicines which it says are ‘ineffective, unnecessary, inappropriate for prescription on the NHS, or indeed unsafe, and that together cost the NHS £128m per year’.

According to the BBC, the 10 products under review include omega 3 and fish oils, travel vaccines and gluten-free foods as well as a range of pain relief drugs for which there is said to be limited evidence. Documents submitted to NHS England – and seen by the BBC – argue that the prescribing of gluten-free products dates back to the 1960s when there was not the choice there is now in supermarkets and shops.

“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,” said an NHS England spokesperson.

Following the review, NHS England will develop new guidance for Clinical Commissioning Groups (CCGs) seeking the views of patient groups, clinicians, commissioners and providers across the NHS.

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Diane Millis

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