Guidance on Self-Care Prescribing
Summary:
For minor short term health problems, patients should access advice and purchase such homely remedies as they and their family need rather than being prescribed by their GP or other clinicians.
Patients are expected, where possible, to try to alter their diet and life-style if it is probable that this is the cause of a minor health problem.
1 Background
1.1 NHS prescribers are often asked to issue an NHS prescription for medications for self-care.
1.2 Warrington Clinical Commissioning Group spent approximately £1million last year on these medicines. This money could be better spent on reducing Health Inequalities across the town for the benefit of the wider population.
1.3 Many of these products are readily available, along with advice, from local pharmacies. Some are also available from local shops and supermarkets.
1.4 This guidance will provide everyone in Warrington with the same expectation of what will be provided from their GP practice or other prescriber.
1.5 The principles of this document apply equally to any provider delivering NHS Commissioned Care.
2 Scope
2.1 This guidance applies to all services contracted by or delivered by the NHS across Warrington CCG, including:
GPs, any other prescribers, Acute Hospitals, NHS community providers, Out Patient clinics, and independent providers.
2.2 This guidance covers the provision of prescriptions to a patient registered on the list of a general medical practitioner, or temporary resident.
3 Prescribing for self-care
3.1 Warrington CCG recommends that the following are suitable for patients to buy for themselves, rather than being prescribed by their GP practice or other prescriber:
- Pain killers for minor aches and pains - unless there is an immediate clinical need in which case a small amount may be prescribed to cover the episode
- Vitamins - unless there is a clinical need, this will be determined by your GP
- Ear wax removers
- Lozenges, throat sprays, mouthwashes, gargles - except for seriously ill patients i.e. patients at end of life or receiving cancer treatments
- Toothpastes – should only be prescribed by a Dentist
- Indigestion remedies for occasional use
- Creams for bruising, tattoos, and scars
- Hair removal creams
- Moisturisers and bath additives for dry skin - unless there is a diagnosed skin condition i.e. eczema
- Sun creams - unless diagnosed photosensitivity as a result of genetic disorders
- Foods and food supplements except where clinically indicated
3.2 The medicines on the list are usually prescribed for minor short term health problems only and where this is not the case they will continue to be prescribed.
3.3 It is not a blanket ban on the medicines and if a patient has a long term condition which they require the medications for their wellbeing they will still be prescribed
3.4 Examples of exceptional circumstances may include the following:
- A homeless person who needs pain killers for a short term ailment but who has no means of paying for over the counter medications.
- A young unemployed person attends their GP practice and is given the option to buy medications themselves but the GP doesn’t believe they have the money available to do so at this time.
- A patient goes to see their GP with indigestion problems. As this is the first occasion they should be advised to buy an indigestion remedy over the counter. However, if the problem persists the issue will be investigated further and medication can be prescribed. Patients with long-term indigestion problems will not be affected.
- A cancer patient has flu and is given the option to purchase remedies themselves but the GP doesn’t believe they will and not having the medication will affect their general health and wellbeing.
- If the GP believes that their patient, who has a learning disability, needs some vitamins but that they don’t fully understand the option of going to purchase medication themselves then they can prescribe this for them.
- A GP believes that their patient, whose first language isn’t English, needs some pain killers. However, they believe that they don’t fully understand the option of going to purchase medication themselves due to the language barrier then medication can be prescribed.
Version: 1.0 Final Approved by Governing Body
Author: Medicines Management Team
Date: January 2016