Please don't ask your doctor for 'over the counter' medicines

People in Norfolk and Waveney are being urged not to ask their doctor for everyday medicines like paracetamol as part of a new campaign.

Norfolk and Waveney’s NHS Clinical Commissioning Groups are asking GPs not to routinely prescribe ‘over the counter medicines’ for some common conditions, unless in exceptional clinical circumstances.

Instead, people are being encouraged to buy them at a pharmacy or shop so that the NHS can spend the money it would otherwise cost on other areas of healthcare. If more people self-care for minor ailments, it could also free up important appointment time at GP practices.

The CCGs have joined forces to launch the new campaign after figures showed the local NHS spent £5.7m last year on remedies for minor conditions such as diarrhoea and indigestion, as well as medicines such as paracetamol.

Of this total, £800,000 was spent on muscle pain medication which costs just £1.60 for patients to buy themselves, while £666,000 went on allergy medication. A further £2m was spent on moisturising lotions – money which could have paid for 339 hip replacement operations.

The Norfolk CCGs carried out an online survey to gather public opinion about the subject, which attracted nearly 400 responses and showed the public were broadly supportive of the concept. Many other areas in England have also taken a similar approach.

Dr Dustyn Saint, GP at Long Stratton Medical Partnership and a member of NHS South Norfolk CCG’s governing body, said: “In the current challenging times, we need to recognise that the NHS only has a finite amount of money and a duty to spend this in a way that achieves the best possible outcomes for all of our patients. We think it is a better option for most people to buy a box of paracetamol for 20 or 30 pence from a supermarket rather than expecting their GP to prescribe the same thing at a significantly increased cost.

“This is not just about money, it is also about prioritising the use of GP appointments, enabling our family doctors to focus on caring for higher risk patients, such as those with complex needs, the very young and elderly, managing long-term conditions and providing new services.

“We do still fully appreciate that there will be instances where a patient’s clinical needs mean that these items will still need to be available on prescription, for example those with long-term medical conditions who require large quantities of certain items.”

Michael Dennis, a medicines management expert with the CCGs, said: “Your first port of call if you’re suffering with a minor illness should always be your pharmacist. They are highly-trained healthcare professionals who can offer help and advice about a huge range of common illnesses without booking an appointment, as well as recommending the right medication to help you self-care at home. By speaking to them first, you could also save yourself a visit to your GP and help free up appointments for other patients in greater need.

“Doing your bit is simple, so please help your NHS by caring for yourself wherever possible and buying your own medicines so that we can make the best use of our resources for the benefit of everyone in Norfolk and Waveney.”

GPs still have discretion to prescribe items depending on clinical circumstances, for example for people who require large quantities of particular medicines for long-term illnesses.

You can follow the campaign on Twitter @YourMED_YourNHS and use the hashtags #selfcare and #askyourpharmacist

Feedback received during the engagement exercise will be posted on the Norfolk and Waveney CCG websites and includes:

• “I think it an excellent idea. I think it may be met with resistance (much like the 5p bag charge at supermarkets) but overall it will not have much impact on people and will be very useful for reducing costs to the NHS. People do not like changes where they have to take more responsibility for the resources they use.”

• “I fully believe and have always believed that we should be buying our own cough mixtures, paracetamol etc etc.”

• “I would be much happier with this arrangement, because it also tells me that my ailment is not thought to be serious enough for specialist medication, and it means there is less strain on the NHS.”

As anticipated, concerns were also raised:

• “Paracetamol only comes in small doses over the counter and I would have to keep leaving the house to purchase whereas I receive 100 from the doctor.” – GPs have clinical discretion.

• “I have a long-term condition which relies on some of these but tend to buy myself anyway rather than add to prescriptions. I would be concerned that people who receive free prescriptions would not be able to continue to receive them if a complete ban on these is put in place.” A ban has not been put in place, the CCGs are supporting GPs to not prescribe the items where they feel it is not necessary. GPs will still be able to prescribe at their discretion for long term conditions and where they feel it is clinically appropriate.

• “I don’t mind paying for a prescription at all but I do prefer the medicine the doctor prescribes than one of the alternatives from the chemist as it doesn’t work as well.” Pharmacists can advise on generic / non-branded medication which contains the same ingredients and works as effectively.