Following a recent public consultation regarding over the counter (OTC) medications, NHS England has issued guidance for medications that should no longer be routinely prescribed, to empower people to self-care and to ensure our limited resources are used in the best possible way. This is particularly focuses on medicines of limited effectiveness, those for self-limiting conditions, and those for conditions that can be easily managed through self-care. Residents are being called on by #HelpMyNHS to  help free up millions of pounds for frontline NHS services by buying low cost medicines (easily available from pharmacies and supermarkets) for short term ailments to help ensure the long-term sustainability of the NHS.

This applies to both children and adults. Exceptions to this will only apply to specific medication required for long-term conditions or for vulnerable people considered unable to self-care. Medicines that can be purchased OTC for the following conditions will no longer be prescribed by your GP, but your local pharmacy can provide advice and medicines for these conditions and more:

• Coughs and colds          · Hay fever                     · Dry skin                            · Dry eyes
• Verrucas and warts       · Insect bites/stings         · Ear wax                             · Indigestion
• Period pain                   · Diarrhoea (adults)        · Simple sprains                    · Cold sores
• Head lice                      · Cradle Cap                   · Haemorrhoids                    · Ringworm/athletes foot
• Dandruff                      · Excessive sweating        · Sunburn                            · Mouth ulcers
• Thrush                         · Infant Colic                   · Threadworms                     · Travel sickness

A full list of affected medications can be found on our website. From the 1^st September 2019, we will no longer be routinely prescribing these medications.

There are several aims of this policy:

To save the NHS money and to reduce unnecessary GP consultations. The NHS only receives a defined budget, and money spent on medication that could be purchased OTC is then not available for other needs. There are roughly 57 million GP consultations for minor conditions each year, which costs the NHS £2.3 billion per year. In 2017 the NHS spent £568 million (£18 million in E. Sussex) on prescriptions for medicines that could be cheaply bought OTC from pharmacy and supermarkets. If more people take responsibility for their self-care by using OTC medicines, the NHS will have more money to spend on nurses, cancer treatments and GP services.

To empower patients to take more responsibility for their own health and manage minor medical ailments themselves. Currently 90% of consultations for minor conditions end up with a prescription being issued, but of those medications 80% could have been bought over the counter. Every time an NHS prescription is dispensed from a UK pharmacy it costs the NHS £9, which is either paid by the NHS itself (if a patient is exempt) or by the patient themselves, and is often far more than the cost to buy OTC.

Generic own-brand medications (i.e. ibuprofen) work as well as branded medications (i.e. Nurofen).

Below are supermarket prices for some common medications that cost considerably less than a prescription:

• Vitamin D = £1 for one month
• Ibuprofen = £1.05p for eight days fulldose
• Paracetamol = £1.20p for 8 days fulldose
• Loratadine (antihistamine) = £2 for one month
• Bottle of child ibuprofen or paracetamol = £1.95
• Gaviscon own-brand 500ml = £4.50
• Lubricating dry-eye drops = £2.50
• Clotrimazole (for fungal infections/thrush) = £4.10
• Mebendazole (enough for 3 people for threadworm) = £7.19 (online)

Simple medications such as these can be seen as a normal part of our own selfcare within a typical grocery shop, alongside food/suncream/toothpaste/shampoos/moisturisers/etc. Speak to your local pharmacy about stocking up on medications to treat common conditions for you and your family. By keeping a selection of essential medication at home you can treat common conditions in a timely manner, and avoid unnecessary trips to your doctor and/or even visits to the A+E.

Examples of over the conditions and over-the-counter products not suitable for prescribing

Minor conditions associated with pain/fever              Ear wax drops, Cold sore creams, Sore throat          Hayfever/Rhinitis

Paracetamol                                                                     Difflam soray                                                               Antihistamines (i.e. Cetirizine, 
 
Ibuprofen                                                                        Benxydamin spray                                                        Loratadine, Piriton)

Aspirin                                                                                                                                                              Nasal sprays (i.e. Beconase,       

Deep heat                                                                                                                                                         Flixonase)

Ibuprofen gel 

Voltarol gel 

Colic                                                                              Dry eyes                                                                    Ringworm/athletes foot

Simethicone drops                                                          Artificial tears (i.e. hypromellose,                                Antifungal creams (i.e. miconazole, 

Infacol                                                                           optrex, vicotears)                                                      canestan)

Coleif                                                                                                                                                            Excessive sweating

Head lice                                                                      Infrequent constipation                                              Suncreams

Lyclear, permethrin, dimeticone, etc.                              Laxatives (i.e. movicol, laxido, senna, lactulose)

Diarhoea (adults only)                                                Haemorrhoids                                                              Supplements and vitamins

Loperamide/Imodium                                                     Non-steroid containing products (i.e. ansuol)                    Multivitamins

Rehydration sachets (i.e. dioralyte)                                                                                                                     Vitamin D 1000 units or less

Dandruff                                                                        

Shampoos (i.e. Capasal, T-gel, nizoral)

Mild dry skin                                                             Infant formula (except for pre-term                             Threadworm

Moisturisers (i.e. E45, oilatum, doublease)                   or cows milk protein allergy)                                          Mebendazole

                                                                                                                                                                               Ovex 

Warts and verrucae                                                   Mild irritant dermatitis                                                     Indigestion and heartburn

Salicyclic acid                                                              E45 itch                                                                              Gaviscon

Bazuka                                                                        Eurax                                                                                 Peptac

                                                                                    Hydrocortisone 1% cream                                                  Rennie