25 APR 2018

What has changed?

Last year the NHS Clinical Commissioners (NHSCC) and NHS England ran a public consultation asking for views on restricting the prescribing of 18 medicines in primary care and future restriction of a further 3,200 products that are available over-the-counter without a prescription. Following the end of the consultation, NHS England published the findings alongside final guidance for Clinical Commissioning Groups (CCGs).

NHS England has made it clear that the new restrictions do not apply to the following categories:

  • Those who suffer from long-term conditions
  • Those unable to self-care due to; medical reasons, mental health problems or who are socially vulnerability

The new guidance lists 37 conditions for which prescribing should be restricted along with a rationale for the recommendations and exceptions. NHS England aims to create a coherent national approach to prescribing in order to save both time and money.

Each year the NHS currently spends 1:

  • £22.8 million on constipation ­ enough to fund around 900 community nurses
  • £3 million on athletes foot and other fungal infections ­ enough to fund 810 hip operations
  • £2.8 million on Diarrhoea ­ enough to fund 2912 cataract operations


How well has the guidance been received?

The new guidance has been met with mixed reactions. The main issue pharmacy bodies and societies seem to have is a fear that the restrictions could put vulnerable people at risk. Helga Mangion (Policy Manager) from the National Pharmacy Association commented that ‘some of the treatments on this list might only cost a couple of pounds privately, but for our poorest that’s a couple of pounds they cannot afford.’

Sandra Gidley (English Pharmacy Board Chair) at the Royal Pharmaceutical Society, mirrored Ms. Mangion’s concerns and quoted that, ‘people may be denied treatment because of their inability to pay.’ 2

Others have welcomed the change like Alastair Buxton (Director of NHS Services) at the Pharmaceutical Services Negotiating Committee who believes that ‘the guidance is a significant step for the NHS to take, as it looks to find ways to tackle affordability challenges.’3

Regardless of the mixed opinions, the transfer of work from GP’s to community pharmacies may increase workload and we encourage our pharmacies to remain diligent through the transition.

Full list of conditions can be found here. (https://www.england.nhs.uk/wp-content/uploads/2018/03/otc-guidance-for-ccgs.pdf )


  1. NHS England. ‘NHS England frees up millions of pounds which could be used for frontline services’ [online] Viewed April 2018 https://www.england.nhs.uk/2018/03/nhs-england-frees-up-millions-of-pounds-which-could-be-used-for-frontline-services/
  2. PSNC. ‘NHS England issues final OTC guidance for CCGs’ [online] Viewed April 2018 https://psnc.org.uk/our-news/nhs-england-issues-final-otc-guidance-for-ccgs/
  3. The Pharmacist. ‘Pharmacy bodies show mixed reactions to new OTC guidance’ [online] Viewed April 2018 http://www.thepharmacist.co.uk/pharmacy-bodies-show-mixed-reaction-to-new-otc-guidance/