Items which should not routinely be prescribed in primary care – consultation response

We responded to the NHS England / NHS Clinical Commissioners consultation in 2017 to strongly advise that some children will be particularly vulnerable to the proposed changes and recommendations.

NHS England and NHS Clinical Commissioners partnered to issue additional guidance to Clinical Commissioning Groups to ensure consistency and address unwarranted variation in prescribing policies. The items included plasters, vitamins, allergy treatments and travel vaccines.

Our response

  • Children from disadvantaged / lower socio-economic backgrounds will be disproportionately affected by this guidance. Increasing poverty levels may discourage parents / carers from purchasing many of the medicines listed in the consultation document.
  • The RCPCH is very concerned that by removing free prescriptions, this will exacerbate existing inequality levels and impact upon the rising number of children living in poverty.
  • We support the role of NHS England in regularly reviewing and researching the efficacy of medications – the prescription of all drugs should be grounded in robust medical research and evidence-based practice. Where there is not a strong evidence base, identification for possible removal should be consulted with key expert groups including feedback from children and young people and their parents/carers.

Our recommendations

  • The items included in the guidance document should be ring-fenced and be available for free prescribing in primary care settings for children up to the age of 18 years, and up to 25 years for young adults with special or complex needs who are undergoing transition into adult services.
  • The RCPCH should be involved and engaged in any future CCG decision making processes as we represent an authoritative lead in advising on medications for children.

Additional note: In August 2018, the RCPCH Vice President for Health Policy wrote to the NHS England medicines team with concerns that children and young people were not clearly recognised within the exceptions guidance of the final document. The letter highlighted that NHS England should review its guidance for a number of over the counter products, including analgesics, eczema creams, antihistamines, nasal sprays and gluten free foods to enable children to access these products in primary care. Please refer to the full response for more detail on our recommendations. 

We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: