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Primary care

More patient involvement needed as NHS proposes further restrictions on prescribing, RPS says

The Royal Pharmaceutical Society has expressed its concern over the “lack of patient engagement prior to initial options for change being developed”.

Eczema cream being applied to hands


The Royal Pharmaceutical Society has expressed reservations about proposed restrictions on bath and shower preparations, as it might lead in an increased use of leave-on emollients

Patients should be represented on the NHS England working group that issues guidance on items that should not be routinely prescribed in primary care, the Royal Pharmaceutical Society (RPS) has said.

The RPS made the comments in response to NHS England’s consultation on eight items that should not routinely be prescribed in primary care, which closed on 28 February 2019. The consultation proposed new guidance on items, including blood glucose testing strips for type 2 diabetes mellitus and clothing for patients with eczema or dermatitis.

In November 2017, NHS England published guidance on 18 items that it said should not be routinely prescribed in primary care. In March 2018, it followed this up with recommendations to restrict the routine prescribing of over-the-counter medicines for 35 minor or short-term health conditions.

“Having been involved in the NHS England working group we are concerned about the lack of patient engagement prior to initial options for change being developed”, the RPS said in its response to the latest consultation.

“There are no patient representatives on the working group and we would recommend that National Voices, Patients’ Association and Healthwatch England are invited onto the group.

“There should be significantly more engagement with patients who may be affected by the recommendations made in this and future guidance.”

Responding to the latest consultation, the RPS has agreed with NHS England’s proposed guidance for five of the eight items, including minocycline for acne and silk clothing for eczema or dermatitis. But it expressed reservations about proposed restrictions on bath and shower preparations for dry and pruritic skin conditions, warning that this might lead in an increased use of leave-on emollients, which present a potential fire hazard.

The RPS also wanted to see more evidence that cheaper glucose monitors and testing strips, and needles for prefilled and reusable insulin pens, are as “effective and as easy to use” as the more expensive versions for people with diabetes.

The Society recommended that the proposed new restrictions be subjected to a cost–benefit analysis.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206235

Readers' comments (1)

  • I agree with RPS that cost-benefit analysis is required for type 1 diabetic patients who may be switched to cheaper test strips and needles as the implications could be to adversely affect the overall NHS budget should patient management of their condition be compromised.

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