Delivering as a CCG

Outcome of gluten free consultation and over the counter engagement 2018

Greater Nottingham Clinical Commissioning Partnership approve changes to gluten free and over the counter medicines prescribing

The Greater Nottingham Clinical Commissioning Partnership (GNCCP) which is responsible for the funding of local health services has reluctantly made the decision to stop funding the prescribing of gluten free food for people living with coeliac disease and dermatitis herpetiformis and to limit the prescribing of over the counter medicines for minor illnesses from November 2018.

These changes will affect patients across Greater Nottingham – Nottingham City, Rushcliffe, Gedling, Broxtowe and Hucknall.

As is the case in many other areas of the country, the local NHS is under increasing financial pressure, with the demand on NHS services and the costs of new treatments and medicines being more than the money available. To ensure the CCGs are making best use of NHS money, services are constantly reviewed. This review enables the NHS to target its resources at frontline services and people with the most urgent clinical needs.

It is in this context that, in 2018, GNCCP started to review local policies on the prescribing of gluten free products and over the counter medicines for minor ailments.

As part of this review, GNCCP sought the views of Greater Nottingham residents and health and social care professionals, and a six-week public consultation for gluten free food prescribing was launched in June 2018. That was followed by a four-week engagement exercise for prescribing medicines and products to treat short term, self-limiting conditions in Nottingham City in July 2018.

Following the conclusion of the consultation and engagement, recommendations were submitted to the Clinical Commissioning Executive Group and the Joint Commissioning Committee for their decision. Both committees concluded that:

  • Gluten free prescribing should be stopped due to the accessibility and availability of gluten free foods, the vast array of naturally gluten free foods and the current pressures on the local NHS budget
  • In line with recent national recommendations, over the counter medicines for minor illnesses should be restricted in Nottingham City, in line with the rest of Nottinghamshire

Gluten free changes – what does this mean?

Over the counter medicines for short term conditions

Dr Hugh Porter, Chair, Nottingham City CCG

“The NHS is facing severe financial pressures and we have to make some very challenging decisions. We didn’t arrive at this decision on gluten free prescribing lightly.

“Gluten free products are now much more readily available and at a more accessible price. The cost to the NHS on a loaf of gluten free bread is much higher than those bought in a supermarket. In addition, many foods are naturally gluten free and there is a lot of information available to support patients to manage their diet.

“All patients who currently receive gluten free products on prescription will receive a letter explaining the changes and advising them of information, help and support they might find useful to help them manage a gluten-free diet.

We are also putting in place a detailed evaluation to assess the effects of these changes over the coming year “

“The changes to over the counter medicine prescribing bring Nottingham City in line with National NHS guidelines. We will be supporting these changes with a campaign to raise awareness of the importance of self care.

“We will support patients to improve their understanding about how to look after themselves better and work with other healthcare staff to raise the importance of self care.”

If patients have any comments or issues around these changes, they can contact the CCG patient experience team on: 0115 883 9570 or email


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