Changes to the prescribing of over the counter medications

Changes to how the NHS prescribes ‘over the counter’ medicines for minor health conditions In March 2018, NHS England published guidance about reducing the prescribing of medicines or treatments that are available to buy over the counter. This means that certain medicines may no longer be prescribed if you can buy them ‘over the counter’. This leaflet will explain the changes, why they are happening and where you can get more information and support.

What conditions are included in this change?

Medicines available to buy over the counter will not be routinely prescribed for the following 35 conditions:

Acute sore throat	Conjunctivitis	Coughs, colds and nasal congestion
Cradle cap	Dandruff	Diarrhoea (adults)
Dry eyes/sore tired eyes	Earwax	Excessive sweating
Haemorrhoids	Head lice	Indigestion and heartburn
Infant colic	Infrequent cold sores of the lip	Infrequent constipation
Infrequent migraine	Insect bites and stings	Mild acne
Minor burns and scalds	Mild cystitis	Mild dry skin
Mild irritant dermatitis	Mild to moderate hay fever	Minor conditions associated with pain, discomfort and fever (e.g. aches and sprains, headache, period pain, back pain)
Mouth ulcers	Nappy rash	Oral thrush
Prevention of tooth decay	Ringworm/athletes foot	Sunburn
Sun protection	Teething/mild toothache	Threadworms
Travel sickness	Warts and verrucae

Probiotics, and some vitamins and minerals will also no longer be routinely prescribed, because most people can and should get these from eating a healthy, varied and balanced diet. In some special cases patients will still be able to get prescriptions for the conditions (or medicines used to treat them) in the list above.

Why does the NHS want to reduce prescribing of these medicines?

The NHS has to make difficult choices about what it spends taxpayer money on and how much value the taxpayer is getting for that money. Medicines to treat these conditions are available to buy over the counter. Pharmacists can advise patients on self-care and also on which are the lowest cost versions of medicines available. By reducing the amount the NHS spends on treating these minor health conditions, the NHS can give priority to treatments for patients with more serious conditions such as cancer and mental health problems.

What are the benefits of going to the pharmacy instead of making an appointment to see your GP?

Pharmacists have the knowledge and skills to help with many healthcare conditions, and you don’t need an appointment to speak to a pharmacist. Visiting a pharmacist first helps to make more GP appointments available for people with more complex healthcare needs. If you have something more serious, the pharmacist is trained to signpost you quickly to the right medical care.

What can you do?

By keeping certain useful medicines at home you can treat common conditions immediately and you won’t need to see a GP. The medicines you may want to keep at home could include:

• A painkiller to help treat minor conditions associated with pain, discomfort and fever.
• Indigestion medicines, oral rehydration salts and treatments for constipation and diarrhoea.
• Treatments for seasonal conditions such as colds and hay fever.
• Sunblock and after sun.
• Some basic first aid items would also be useful.

If you have children make sure you also have products suitable for children. Speak to your pharmacist for advice on what medicines to keep at home, where to store them safely and how to use your medicines. Ensuring you have a well-balanced, healthy diet will mean most people don’t need to take vitamin supplements or probiotics. If you do wish to take these products to avoid you becoming deficient, you can buy them from a pharmacy, a supermarket or online.

What about patients who need to take medicines for these conditions regularly or in special situations?

Some individual patients may still be prescribed a medicine for a condition on the list. The reasons vary for each condition and GPs, nurses or clinical pharmacists will speak to you individually if this affects you. The main reasons are:

• Treatment for a long-term condition, g. regular pain relief for chronic arthritis, treatments or inflammatory bowel disease.
• Treatment of more complex forms of minor illnesses, e.g. migraines that are very bad and where over the counter medicines do not work.
• Patients prescribed over the counter medicines to treat a side effect of a prescription medicine or symptom of another illness e.g. constipation when taking certain painkillers.
• The medicine has a licence which doesn’t allow the product to be sold over the counter to certain groups of patients. This may vary by medicine, but could include babies, children or women who are pregnant or breast-feeding.
• The prescriber thinks that a patient cannot treat themselves, for example because of mental health problems or severe social vulnerability (not just having a low income).

What if my symptoms don’t improve?

Your pharmacist can advise on how long you can expect to experience symptoms for the conditions listed. If your symptoms have not improved after this time or you start to feel a lot worse, contact your GP or call 111. A&E and 999 should only be used for life threatening emergencies. There is lots of advice on the NHS choices website to help you choose the right service https://www.nhs.uk/NHSENGLAND/ABOUTNHSSERVICES/Pages/NHSservices.aspx

Where can you find more information and support?

• You can speak to a pharmacist who can help with advice and treatments for the conditions listed.
• NHS choices has lots of information and advice on treating minor health problems with self-care https://www.nhs.uk/live-well/healthy-body/home-remedies-for-common-conditions/
• Find out more about the conditions for which over the counter medicines will no longer be prescribed at: https://www.england.nhs.uk/medicines/items-which-should-not-be-routinely-prescribed/