Consultation launched on conditions for prescribing over-the-counter medicines


NHS Clinical Commissioners (NHSCC) and NHS England have launched a joint consultation on commissioning guidance detailing conditions for which over-the-counter items should not routinely be prescribed in primary care.  

It rel="noopener noreferrer" follows on from commissioning guidance published in July on items which should not routinely be prescribed in primary care and marks the next stage in the organisations’ work to identify areas of current NHS spend that could be better used for higher priority areas, such as primary care and mental health.  

“This consultation is an important part of the ongoing work we are doing on behalf of local clinical commissioning groups alongside NHS England to ensure the NHS budget is spent effectively to deliver the best possible patient care and to encourage more people to self-care” Dr Graham Jackson, NHSCC co-chair, and co-chair of the clinical working group that developed the list of conditions said.

'Deploying precious NHS resources'

The work aims to save up to £136 million on prescriptions for medicines to treat ‘minor conditions’ which could otherwise be purchased over the counter from a pharmacy and/or other outlets such as petrol stations or supermarkets. These prescriptions include items for a condition:

  • that is considered to be self-limiting and so does not need treatment as it will heal or be cured of its own accord
  • which lends itself to self-care, i.e. that the person suffering does not normally need to seek medical advice and can manage the condition by purchasing OTC items.
Or items:
  • that can be purchased over the counter, sometimes at a lower cost than that which would be incurred by the NHS
  • for which there is little evidence of clinical effectiveness.

Graham went on to say: “It is important that we have an honest conversation with the public, patients and clinicians about what the NHS should and can provide with the constrained funds it has available. 

"As a part of that, it is right that we review what is currently offered on NHS prescription that is also available over the counter so that we can prioritise our spending on those products that are the most clinically effective and provide the best outcomes for patients.

NHS England chief executive Simon Stevens, said: “To do the best for our patients and for taxpayers it’s vital the NHS uses its funding well. This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing-up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”


The list and approach have been developed based on responses received to a previous consultation on items which should not be routinely prescribed in primary care, refined by the joint NHS England-NHSCC clinical working group and reviewed following initial feedback received from patient representative organisations.

The consultation document sets out proposals for commissioning guidance for CCGs on over-the-counter (OTC) products for 35 minor and/or self-limiting conditions.

The guidance is intended to encourage people to self-care for minor and self-treatable conditions only, rather than for items prescribed to treat long-term conditions and associated symptoms. The guidance also includes some exceptions where ongoing prescribing may be appropriate.

Further information can be found on the NHS Clinical Commissioners website. The consultation ends on 14 March and a series of public engagement events will be announced soon.

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