From April 2019, GPs are no longer routinely providing prescriptions for medications and treatments which can be bought over the counter at pharmacies and supermarkets.
This means that GPs, nurses and pharmacists will not usually prescribe certain medicines for minor health concerns and patients will be asked to purchase them from pharmacies or supermarkets instead.
The changes follow national recommendations from NHS England to encourage people to self-care and to reduce the amount of money the NHS spends on medicines which are available to buy over the counter.
In Leicester, Leicestershire and Rutland, between April 2017 and March 2018, the NHS spent £4.1m on prescriptions for medicines that can be bought from a pharmacy or supermarket. By saving money on items which are readily available, priority can be given to treatments for people with more serious conditions, such as cancer, diabetes and mental health problems.
These changes apply to
These prescriptions also include other common items
People who need medicines to treat a long-term health condition, such as diabetes, or for more complex illnesses, as well as patients on treatments only available on prescription will not be affected by the changes. The changes will also not apply to those who have found that over-the-counter products haven’t helped, or patients who are unable to treat themselves. In all of these cases, prescribers will be able to use their own judgement when deciding whether to issue a prescription.
Dr James Ogle, GP and Clinical Lead for Prescribing at West Leicestershire CCG, said: “The sorts of health conditions these changes apply to include headaches, indigestion, head lice, travel sickness, hay fever, diarrhoea and insect bites and stings.
“Last year the local CCGs carried out a public survey across Leicester, Leicestershire and Rutland, which gave us an understanding of how people would be affected if they had to buy these types of medicines, instead of having them prescribed. Most people told us that they already buy their own medicines to treat minor conditions and are quite willing to do so.
“Community pharmacists are best placed to help and advise you regarding suitable treatments for common ailments. The pharmacist will check the medicine is appropriate for you and your health problem and will ask questions to make sure there is no reason why you should not use the medicine.
“However, if people are still worried after speaking to the pharmacist, or their symptoms get worse or persist, they can of course still make an appointment at their GP practice.”
We know from the public surveys that there are some people who will find it more difficult to self care or to buy over the counter medication. We want to reassure patients that we recognise that a ‘one size fits all’ approach is not always appropriate and they can always talk to their GP if they have concerns for any reason, because GPs will still be able to prescribe in some situations.
We are now providing more information to help people understand their symptoms and build confidence in treating minor illnesses themselves.”
People can access advice on self care at
More information on the changes to prescribing is available at
https://www.england.nhs.uk/medicines/over-the-counter-items-which-should-not-routinely-be-prescribed/ or people can speak to their community pharmacist or GP practice.
Why are we asking you to buy ‘Over the Counter’ medicines for minor ailments, self-limiting conditions and items of low clinical priority.
In 2017 we reviewed how people accessed over the counter medicines for the short term treatment of minor ailments. The sorts of conditions we reviewed included headaches, indigestion, head lice, travel sickness, hay fever, diarrhoea and insect bites and stings.
Since then national guidance was issued by NHSE in March 2018 on “Conditions for which over the counter items should not routinely be prescribed in primary care because in the year prior to June 2017, the NHS spent approximately £569 million on prescriptions for medicines, which could otherwise be purchased over the counter (OTC) from a pharmacy and/or other outlets such as petrol stations or supermarkets.
As a result all of the Leicestershire CCGs have engaged with their respective populations to understand the how people will be affected and from now on will be following the same guidance.
We learnt that the majority of people do already buy their own medicines to treat minor ailments. We also learnt that the majority of people are willing or very willing to buy medicines for minor ailments.
People also told us that the information, advice and guidance that the pharmacists gave them was really helpful and that it was unnecessary to see their GP and they would rather people only used their GP for series conditions which in the long run would improve access for everyone to their GP surgery.
There were some people who were concerned particularly if they had a long term condition and wanted to understand a little more about the effect of mixing medicines. Other people wanted to know more about the quality and strength of over the counter medicines. Some people were concerned about affordability of some medicines.
The CCG think that the NHS belongs to everybody and the results of our survey show that patients feel the same way. Patients also told us that they think resources need to be used in the best possible way for all patients. We are therefore asking GPs not to prescribe medicines on a prescription for the short term treatment of minor ailments, low dose vitamin D supplements for prevention of deficiency and some specialised infant formulas. Patients will be asked to purchase them over the counter (OTC) instead. We are also asking patients not to request these items on their prescription.
We think asking people to self-care in this way is a fair way of utilising resources wisely as most of these items can be purchased in pharmacies and supermarkets at a low cost, but cost the NHS more to prescribe on a prescription.
The review told us that many people already feel that their community pharmacist is their first point of contact. They support them with a range of ailments and they prefer to talk to them about minor conditions savings GP appointment time for more urgent problems.
Community Pharmacists are best placed to help and advice patients regarding suitable treatments for common ailments. However if they are worried or their symptoms get worse or persist they can still make an appointment to see a GP.
We have taken all patient questions, queries and concerns from the review and responded to them and added other information which we think you will find useful.
What is included?
Items for conditions considered to be:
These prescriptions also include other common items:
What are over the counter (OTC) medicines?
Over the counter medicines (OTC) are those that can be purchased in a pharmacy under the supervision of a pharmacist. A limited number of medicines can also be purchased without pharmacy supervision in shops and supermarkets but are often sold in lower pack sizes or lower strengths.
Can Community Pharmacists diagnose minor ailments?
Pharmacists have to complete 4 years of undergraduate training and one year post graduate training and also pass a professional exam before they qualify and practice as a pharmacist. Part of this training includes completion of an accredited training program on minor ailments.
If you are feeling unwell, speak to your community pharmacist as the first port of call. They will be able to recognise symptoms of a minor ailment and offer you advice or treatment accordingly. They will also recognise symptoms are of a more serious or persistent nature and if it is appropriate recommend that you seek further medical advice. However if you are still worried you should make an appointment to see your GP.
You can always call NHS 111, which will help you find the right NHS service.
Can community pharmacists advise me if an OTC will interact with my prescription medicines?
If you are taking medicines prescribed by your GP and you are worried about taking an OTC treatment, a pharmacist will be able to advise you on drug interactions. The pharmacy that dispenses your repeat prescription will be able to check their records of all the medicines that they have supplied you so that they can advise you. Community pharmacists can also view your Summary Care Record which has details of any medicines supplied directly by the pharmacy and also the hospital pharmacy if you are also receiving treatment there.
So wherever you are, the local community pharmacist will be able to check what medicines you take and advise if you are suitable to take OTC remedies.
If they have any queries they will speak to your GP.
You can also be prepared by asking your GP on your next routine visit whether there are any OTC preparations you should avoid.
Can my community pharmacist advise which is the most suitable OTC medicine for me if I have a long term condition?
Again speak to your pharmacist if you have any concerns. They will be able to advise patients on the safe use of OTC of medicines in the majority of cases. If they need further information that you cannot provide, they will be able to contact your GP surgery or advise you to see your GP if appropriate.
What about vitamins and minerals?
Vitamins and minerals are essential nutrients which most people can and should get from eating a healthy, varied and balanced diet. In most cases, dietary supplementation is unnecessary. It is therefore not deemed appropriate for such preparations to be routinely funded on the NHS. However this does apply if you are receiving treatment for a medically diagnosed deficiency.
What if I want to discuss something in private that is intimate or upsetting?
The majority of community pharmacists have a private room for consultations which you can request to use if you want to discuss an intimate or personal problem. At busy times you may have to wait a little while but the counter assistant will be able to advise you if this is the case and how long you will have to wait. However, normally it shouldn’t be a problem to see the pharmacist reasonably quickly.
Your pharmacist can also talk to you confidentially without anything being noted in your medical records, which some people may prefer.
I can’t easily get to my community pharmacy
Most people have access to a community pharmacy within a short distance of their home. However, if you genuinely struggle to get to a pharmacy, then talk to your pharmacist to see if they can help to find a solution.
It is also worth keeping a small supply of some OTC treatments at home in your medicines cabinet so that you have them at hand in the first instance if you don’t feel well. Watch our short video for advice on what to keep at home.
The quality of OTC medicines is not as good as medicines supplied on a prescription
The quality of medicinal treatments is regulated by the Medicines and Health Regulatory Authority (MHRA). This means that all licensed medicines bought over the counter must go through detailed safety and quality tests. There should be no noticeable difference in treatment of symptoms between a medicine that you can buy and those supplied on prescription.
I can only buy a small quantity of medicine over the counter
There are restrictions on the quantity of some OTC medicines that you can buy at any one time but these should be enough to manage a minor illness. Larger quantities can be sold by a pharmacy than in supermarkets. Your pharmacist can advise you on what the limits are.
Will I have to purchase OTC medicines if I have a long term condition?
If you require regular, long-term treatment with a medicine then this will be prescribed for you if your GP thinks you need it, even if it can be purchased OTC. However, unless you require a medicine on a regular basis you will be expected to purchase OTC preparations for minor illnesses like everyone else.
Your GP may also remove some OTC medicines from your repeat prescription if you are not taking them regularly and ask you to purchase it when you need it. You can help by letting your GP practice know if you have over the counter medicines on your repeat prescription and you don’t take it regularly.
Why do the prices of OTC medicines vary so much?
Prices of similar preparations vary between pharmacies and it is worth shopping around if you know what you need. Some pharmacies have websites which will tell you the products that they stock and prices.
➢ Contact a Pharmacy near you.
➢ Compare supermarket prices of some OTC preparations.
It may be worth asking your pharmacy if they stock non-branded products which may be cheaper than their branded equivalents.
Will this affect me if I have a pre-paid certificate?
If you have a pre-paid certificate you will also be asked to purchase your OTC treatments for minor ailments. However, if you need regular treatment for a chronic condition, then this will be supplied on prescription covered by your pre-paid certificate.
What about administering OTC to small children at school or nursery?
The majority of treatments for minor ailments can be given before the school day starts and last long enough so that another dose does not have to be given until the child returns home. These should be purchased over the counter. Please don’t ask your GP to prescribe paracetamol or ibuprofen “just in case” for this purpose.
This advice does not apply to you if your child receives paracetamol or another analgesic on prescription for long term management of chronic pain. If this is the case please refer to your school’s Medicine Policy.
What if an OTC medicine has been started by the hospital?
If you are admitted to hospital, you will be given an adequate supply of medicines when you are discharged which will be free of charge. This may also include medicines for minor ailments if you have been prescribed these during your stay and it is thought that a further supply will help your recovery when you go home. However, if they are not required on a regular long term basis, then they will not be added to your repeat prescription and you will be asked to purchase them in the future.
What if I am in a residential home?
In Leicestershire, Care Homes are expected to provide a limited range of OTC medicines to adult service users who require symptom relief for treatment of headache, back ache or muscular pains, fever, constipation, cough, indigestion and coughs for up to 48hrs. The medicines can be provided without calling out the GP.
However, if there is cause for concern, the care home staff should consult with either their community pharmacist or their GP practice.
Rosebery Pharmacy is open 6.30am-11.30pm. Visit or phone us today for FREE advice, FREE repeat prescriptions and FREE delivery! Phone us on 01509 260330.
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