Proposed changes to prescribing in Croydon MALARIA TABLETS Consultation on proposed changes to NHS prescriptions in Southwark
NHS Croydon Clinical Commissioning Group Contents Who are we and what is this document about? 3 What are we proposing? 4 Over-the-counter medications 4 Malaria prevention medicines for travel 7 Selected travel vaccinations 7 Why do we want to make these changes? 8 Have your say 9 How we spend NHS money in Southwark 10 When will we decide? 11 2 Consultation on proposed changes to NHS prescriptions in Southwark
Proposed changes to prescribing in Croydon Who are we and what is this document about? This document has been produced by NHS Southwark Clinical Commissioning Group (CCG). We are made up of all GP practices in Southwark and we are responsible for buying healthcare services for the 323,000 patients who are registered with a GP in the borough. This includes NHS services like emergency care, hospital care, community and mental health services, and medicines that are prescribed by a GP. We are committed to providing the best possible healthcare services locally and for making the best use of the funding that we receive from the Government. To ensure we make the best use of the money we have available, we are proposing to make some changes to the guidance for prescribing: Over-the-counter medicines Malaria prevention medicines Selected travel vaccines This document explains our proposals and how you can tell us what you think as part of a formal consultation exercise. Our consultation starts on 26 June and ends on 20 August 2017. 3 Consultation on proposed changes to NHS prescriptions in Southwark 3
NHS Croydon Clinical Commissioning Group What are we proposing? At the moment, these medicines are usually available on NHS prescription from a Southwark GP: Over-the-counter medication for short-term minor illnesses and injuries and health supplements MALARIA TABLETS Malaria prevention medicines for travel NHS prescriptions for selected travel vaccinations. We are proposing to no longer support the routine prescribing on the NHS of these products. Over-the-counter medications We propose to stop prescribing on the NHS over-the-counter medicines for short term minor illnesses and conditions. These are products that can be bought over the counter from a pharmacy, without a prescription. Most minor illnesses can be treated through self-care without the need to see a doctor and will get better with time. If a medicine is needed to treat symptoms such as a headache, these are widely available and can be bought over the counter for example from a pharmacy or supermarket. Your local community pharmacist, such as those on the high street, 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. 4 Consultation on proposed changes to NHS prescriptions in Southwark
Proposed changes to prescribing in Croydon The over-the-counter medicines 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 Eye 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 Mouth ulcers treatment 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 We are not proposing changes to the use of over-the-counter medicines to manage long term conditions, for example, regular pain medicine for osteoarthritis. Pharmacy First Scheme In Southwark, we currently have a scheme called Pharmacy First to help promote selfcare through community pharmacies. Under this scheme, patients who do not have to pay for prescriptions (who are exempt ) can get certain medicines they need free of charge from their pharmacy without a prescription from their GP. Most of the medicines in our proposal are covered by Pharmacy First (see next page). Patients who currently get the medicines they need under Pharmacy First will still be able to do so, whatever the outcome of this consultation. If any changes to prescribing guidance are introduced as a result of this consultation, we may review the impact of this on the Pharmacy First scheme in the future. Consultation on proposed changes to NHS prescriptions in Southwark 5
NHS Croydon Clinical Commissioning Group Medicines included in this proposal which ARE covered by Pharmacy First Analgesics (painkillers) for short term use Haemorrhoidal preparations for short term use Anti-diarrhoeal medication for short term use Antifungal treatment for short term minor ailments Cold sore treatment Cough and cold remedies Ear wax removers Eye infection treatments Indigestion remedies Laxatives for short term use Mouth ulcers treatment Nappy rash treatment Hay fever medicines Threadworm tablets Headlice treatment and scabies treatment Topical steroids for short term use for bites, stings or mild dermatitis Medicines in the proposal which are NOT covered by Pharmacy First Antiperspirants Colic treatment Eye lubricating products Herbal and complementary supplements Mouth wash Topical acne treatment which is available over the counter Vitamins and minerals (excluding Vitamin D for infants and expectant mothers) Warts and verruca treatment 6 Consultation on proposed changes to NHS prescriptions in Southwark
Proposed changes to prescribing in Croydon Malaria prevention medicines for travel MALARIA TABLETS Selected travel vaccinations We propose to stop prescribing malaria prevention medicines for use in travel on an NHS prescription, to bring us in line with national guidance. NHS patients are entitled to receive free advice about travel from their GP or community pharmacy. GP practices will be able to issue private prescriptions for malaria prevention medicines and continue to offer travel advice, or patients can seek advice from private travel clinics. Certain vaccines are not routinely provided on the NHS for travel purposes. In line with national policy, we propose to stop offering the following vaccines for travel on the NHS: Hepatitis B (single agent 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. Talk to your GP, practice nurse or pharmacist for further information. 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. Consultation on proposed changes to NHS prescriptions in Southwark 7
NHS Croydon Clinical Commissioning Group Why do we want to make these changes? To promote self-care Self-care is about avoiding becoming ill, treating common illnesses at home and seeking help when needed. The medicines covered in this proposal are available from your pharmacy. The NHS recommends everyone keeps a medicine cabinet stocked with essential medicines. To free up doctor and nurses time for those most in need It is estimated that about 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 time limited conditions, and to reduce unnecessary demand on GP time, including the out of hours service. This will free up doctor and nurses time for people who have more complex healthcare needs and who need more active support in managing their health. To bring us in line with national guidance Southwark is one of only three clinical commissioning groups nationally still offering malaria prevention medicines on NHS prescription. The other two CCGs are also carrying out similar consultations about whether to continue prescribing them. The proposals for discontinuing malaria prevention medicines on 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. Proposals to discontinue providing selected travel vaccines have been developed in consultation with public health colleagues and aim to standardise local provision of the specific travel vaccines. These proposals are part of Southwark plans within 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. To get the best value from the funding we have available The primary care prescribing budget for Southwark is around 32 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 750,000 a year to the NHS in Southwark. This will be invested in other healthcare services for local people. 8 Consultation on proposed changes to NHS prescriptions in Southwark
Proposed changes to prescribing in Croydon How we spend NHS money in Southwark The CCG received 450 million for 2017/18 from the Government and has allocated 433 million to spend on healthcare for the people of Southwark. This equates to around 1,461 per person. Transformation 2m Better Care Fund (mainly Southwark Council) 16m Other, including corporate costs and reserves 17m Prescribing for local people is 7.3% of our budget. Community & Other Primary Health Care 41m Prescribing 32m Hospital 221m Delegated Primary Care Commissioning 43m Continuing Care and Funded Nursing Care 16m Mental Health 61m Our proposals to change guidance for certain medicines would potentially save Southwark around 750,000 a year which we would invest in other health services. This represents 2% of the prescribing budget. Consultation on proposed changes to NHS prescriptions in Southwark 9
Have your say We are taking views from local people, patients, carers, clinical staff and other interested parties and we will use these views to help us make our decision. We are keen to hear from you if you live in Southwark, or if you are registered with a Southwark GP, 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 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 Southwark How we should communicate with Southwark people about our decision and our plans. You can give your views by: Filling in our short survey: www.southwarkccg.nhs.uk. Paper copies are also available at public venues across the borough. Emailing us: souccg.southwark-ccg@nhs.net Writing to us at: Prescribing Views, NHS Southwark CCG, FREEPOST RSCY- ACYH CAZL, 1st Floor, Hub 5, PO Box 64529 London SE1P 5LX. No stamp needed. Dropping by our stall at the Our Healthier Southwark STP event on 11 July, 5pm to 8pm at Walworth Methodist Church. Discussing at your practice s Patient Participation Group meeting, if it takes place within the consultation timeframe. Ask at your GP reception when the next one is. Inviting us to come and speak to members of your local group Calling us on 020 7525 7888. The closing date is 20 August 2017. 10 10 Consultation on proposed changes to NHS prescriptions in Southwark
When will we decide? After this consultation closes on 20 August, we will consider fully all the views we have heard. We expect to reach a decision about our proposals at our Governing Body meeting on 14 September. This meeting takes place in public and you are welcome to attend to hear our discussions. You can find details of our meetings on the NHS Southwark CCG website: www.southwarkccg.nhs.uk 11 Consultation on proposed changes to NHS prescriptions in Southwark 11
NHS Southwark CCG PO Box 64529 London SE1P 5LX Tel: 020 7525 0400 Email: souccg.southwark-ccg@nhs.net www.southwarkccg.nhs.uk