Delivering as a CCG

Have your say about gluten free food on prescription (2018)

People across Greater Nottingham are being asked to take part in a consultation to review the provision of gluten-free foods on prescription.

Health commissioners from the four Greater Nottingham Clinical Commissioning Groups are consulting on whether the NHS should restrict or stop gluten-free food on prescription.

Currently,  £176,488 is spent on prescribed gluten free foods each year across the areas they serve.

The six-week consultation will run Thursday 14 June to Thursday 26 July and commissioners are asking people to complete a short survey to help them to understand what people think about the different options.

Some gluten-free foods like bread and flour are currently available on prescription for people who have coeliac disease – a common digestive condition triggered by the protein gluten, which is found in wheat, barley and rye.

Symptoms of coeliac disease range from being mild to severe and can include abdominal pain, diarrhoea, nausea, weight loss, headaches and osteoporosis. There is no cure for coeliac disease, but switching to a gluten-free diet can help.

Prescriptions for gluten-free foods have been available for more than 30 years, and were introduced when gluten-free alternatives were more limited and more expensive. However, since then the availability of gluten-free foods has increased dramatically in supermarkets, grocers and even restaurants, and now many non-coeliac patients are voluntarily excluding gluten from their diet.

Patients registered with a GP in areas served by Nottingham City CCG, Nottingham North and East CCG, Rushcliffe CCG and Nottingham West CCG are being asked to give their views on the three options being proposed by health commissioners:

  1. Limit prescribing for all patients in Greater Nottingham to four units of long life bread and flour per month. This will mean that the same prescribing model is in place across the south of the county, including the city. It is the closest model to the national guidance and provides savings for the CCGs while still enabling gluten-free food to be available on prescription.
  2. All Greater Nottingham CCGs to stop all gluten-free prescribing, with the exception of for children, who will be able to receive up to four units of long life bread and flour per month. This would provide a more significant saving for the CCGs while still allowing gluten-free prescribing for children.
  3. All Greater Nottingham CCGs to stop all gluten-free prescribing.  This would mean the same restrictions will be in place across Nottinghamshire (except Bassetlaw). It provides the greatest financial saving for the CCGs.

Dr Hugh Porter, GP and Clinical Lead for NHS Nottingham City CCG says: “Gluten is not essential to people’s diets, and many basic foods such as vegetables, potatoes, meat and rice are naturally free from gluten. Many gluten-free alternatives are also now widely available to buy in supermarkets and health food shops.

“Given the ever-growing pressures on NHS services and budgets, we must ensure we get the best value for taxpayers’ money. We understand the proposals to limit, or even withdraw, gluten-free foods on prescription may have an impact on some patients with coeliac disease, but that’s why we are keen to hear as many views as possible to help inform our decision.”

Read the consultation document here.

Check out our County events here.

Check out our City events here.

For the National consultation click here

For the outcome of the South County 2015 consultation click here

Extra information…

  • Across Greater Nottingham and Mid-Nottinghamshire, there are currently differences in how much gluten free food is prescribed to people living with coeliac disease – see below.
  • South Nottinghamshire  (NHS Nottingham North and East (Gedling and Hucknall), NHS Nottingham West (Broxtowe) and NHS Rushcliffe) – four units in total of long life bread and/or  flour each month are available on prescription for patients with a diagnosed condition of coeliac disease or dermatitis herpetiformis.
  • Mid Nottinghamshire (Mansfield and Ashfield and Newark and Sherwood – no prescribing of gluten free foods.
  • Nottingham City – Nottingham City currently follow the prescribing guidelines in the table below.
Age and gender Number of units
Child (1-3 years) 10
Child (4-6 years) 11
Child (7-10 years) 13
Child (11-14 years) 15
Child (15-18 years) 18
Male 19-59 years 18
Male 60-74 years 16
Male 75+ years 14
Female 19-74 years 14
Female 75+ years 12
Breastfeeding Add 4
3rd trimester pregnancy Add 1

 

One unit is the same as: 400g loaf of bread or 250g of pasta or two pizza bases

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