NHS doctors may be stopped from providing travel vaccinations and prescriptions for hayfever tablets, indigestion remedies and omega 3 supplements under major cost-cutting plans.
Coeliacs could also have to buy their own gluten-free food, which will no longer be available on the NHS as part of a proposed crackdown on “low value” prescription items available in supermarkets and over the counter for a fraction of the cost.
NHS England hopes to save up to £400m a year under new national guidelines.
A consultation will be launched next month after local health posses identified “significant areas” where savings could be made.
The guidelines for clinical commissioning groups (CCGs) will initially be developed around a set of 10 medicines deemed ineffective, unnecessary or inappropriate for the NHS.
The review, which will take into account the views of patient groups, clinicians and providers, could extend to over-the-counter medicines which can often be bought at a much lower cost without prescription.
This could include items such as paracetamol, sun cream, cough and cold treatments, and heartburn and indigestion tablets, which are thought to cost the service £128 million per year, NHS England said.
Lidocaine plasters – for back or joint pain – and fentanyl, a painkiller for cancer patients, are among the 10 items under the focus of the initial consultation.
Travel vaccines protecting against typhoid, hepatitis A and cholera, and a triple jab for diptheria, polio and tetanus, will also be subject to review.
“Part of what we are trying to do is make sure that we have enough headroom to spend money on the innovative new drugs by not wasting it on these kinds of items,” Simon Stevens, chief executive of NHS England, told the Daily Mail.
A spokesperson for NHS England said: “New guidelines will advise CCGs on the commissioning of medicines generally assessed as low priority and will provide support to clinical commissioning groups, prescribers and dispensers.
“The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes.”
Around one in 100 people have coeliac disease, caused by a reaction to gluten, that can be treated by cutting the substance from a patient’s diet.
Once diagnosed as coeliac by a doctor, patients in most parts of the UK can receive gluten-free staple foods from a pharmacy through a prescription from a GP.
Foods approved for prescription include bread or rolls, breakfast cereals, crackers and crispbreads, flour and flour-type mixes, oats, pasta and pizza bases.
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The amounts of gluten-free staple foods a sufferer can receive each month are controlled by the National Prescribing Guidelines.
Vaccines for typhoid, hepatitis A and cholera and a combined jab for diptheria, polio and tetanus are usually available free on the NHS.
The health service offers the vaccinations free of charge because they protect against diseases deemed to present the greatest risk to public health if brought into the country by travellers.
Some countries require visitors to be vaccinated against diseases such as yellow fever or meningitis prior to arrival, while travellers to some parts of the world are advised to have inoculations against a range of other diseases, including tuberculosis, hepatitis B, Japanese encephalitis and tick-borne encephalitis.
These are not usually available on the NHS and can cost around £50 for each dose.
Suncream is also available on prescription for patients diagnosed with photodermatoses, a group of skin conditions associated with an abnormal reaction to ultraviolet (UV) radiation.
The National Institute for Health and Care Excellence (Nice) recommends that sufferers use high SPF sun creams from spring to autumn – but they may have to buy it at the chemist in future.
Painkiller co-proxamol, fish oil tablets prescribed to promote healthy hearts in patients at risk of heart disease, muscle rubs and thyroid hormone liothyronine are also subject to review under the plans.
Additional reporting from Press Association