This website uses cookies to function correctly.
You may delete cookies at any time but doing so may result in some parts of the site not working correctly.

Prescribing updates 2018

POSITION STATEMENT FOR: PRESCRIBING PREPARATIONS AVAILABLE TO PURCHASE OVER THE COUNTER (OTC) FOR SELF CARE

Part of NHS Lambeth CCG’s “Healthier Together” Five Year Strategy is to deliver best value by ensuring that we live within our means and use our resources well. Therefore to help us deliver our strategy and continue to support the cost effective, evidence based use of medicines, NHS Lambeth CCG no longer supports the routine prescribing of medications for acute (short-term) illnesses, minor and/or self-limiting conditions; and health supplements.

Why are we doing this?

  • To encourage patients to self care i.e. to take actions for themselves, on behalf of and with others in order to develop, protect, maintain and improve their health, wellbeing or wellness
  • To empower patients to manage minor self-limiting conditions at home with support from community pharmacy; and seek help when needed
  • To ease the pressure on NHS services by reducing demand on prescriber consultation time, including out of hours services, for acute (short-term) illnesses, minor and/or self-limiting conditions
  • To help contain the costs of medicines on the local NHS budget
  • To free up clinician time for people who have more complex healthcare needs and who need more active support in managing their health
  • To increase patient awareness of preparations which are of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness and/ or can be purchased over the counter

Further information can be found in our NHS Lambeth CCG Governing Body Meeting in Public Report Proposals for local guidance on NHS Prescribing in Lambeth. June 2016

What treatments and preparations for acute (short-term) illnesses, minor and/or self-limiting conditions are included and why?

  • Pharmacy Only (P) and General Sales Lists (GSL) treatments that can be purchased over the counter from a pharmacy with or without advice
  • GSL treatments (including a patient information leaflet) that can be purchased from other retail outlets such as supermarkets, petrol stations, convenience and discount stores
  • Treatments that are used to treat a condition that is considered to be self-limiting and so
  • does not need treatment as it will heal/resolve by itself; and/or
  • Treatments that are used to treat a condition which lends itself to self care i.e. that the person suffering does not normally need to seek medical care and/or treatment for the condition
  • Treatments that are often available to purchase over the counter at a lower cost than would be incurred by the NHS on a prescription.

Guidance for patients, carers and guardians

  • The NHS recommends everyone keeps a well-stocked medicine cabinet with self care medicines. Further information can be found here: http://www.nhs.uk/Livewell/Pharmacy/Pages/Yourmedicinecabinet.aspx
  • Community pharmacists can offer advice on how to self care, manage your acute (short-term) illnesses and minor/self-limiting conditions, when to seek medical advice, and what to take if you are on other medication. You do not need to make an appointment to see the pharmacist, and many pharmacies are open late nights and at the weekend when the doctor’s surgery is closed.
  • If your problem is more serious and needs the attention of another healthcare professional such as your GP, the pharmacist will advise you on this.

Examples of treatments available to purchase over the counter, which should no longer be routinely prescribed in Lambeth. THIS LIST IS NOT EXHAUSTIVE.

Treatments

[acute (short term), minor and/ or self-limiting condition commonly used to treat]

Examples of preparations in each area (NB This is not an exhaustive list)
Acne treatment – topicalBenzoyl peroxide, potassium hydroxyquinoline sulphate

Analgesic treatment for short term use

(acute pain, fever, headache, soft-tissue injury, musculoskeletal joint injury)

Paracetamol tablets and liquid,

ibuprofen tablets and liquid,

topical analgesics [Non-Steroidal Anti-inflammatory Drugs (NSAIDs)] and rubefacients

Anti-fungal treatment

(athlete’s foot, oral and vaginal thrush, ring worm)

Clotrimazole cream/pessaries/topical spray,

fluconazole oral capsule, ketoconazole shampoo,

terbinafine cream/spray, amorolfine nail laquer

Antiperspirant treatment

(excessive sweating)

Aluminium chloride hexahydrate
Cold sore treatment

Aciclovir cream, penciclovir cream, cetrimide,

cold sore patches

Colic treatmentSimeticone, dimeticone, lactase enzyme, gripe water
Constipation treatment for short term use, less than 72 hoursSenna, ispaghula husk, docusate sodium, lactulose, sodium picosulfate
Cough, cold and sore throat treatmentCapsule, tablet, syrup, linctus, powder, lozenge and pastille preparations for coughs, colds and sore throats
Diarrhoea treatment for short term use, less than 72 hours

Loperamide,

oral rehydration salts

Ear wax removerOils, sodium bicarbonate, urea hydrogen peroxide, docusate sodium
Eye treatments for infected or dry eyes

Chloramphenicol eye drops/ointment, artificial tears and ocular lubricants containing hypromellose, carmellose, carbomer, sodium hyaluronate, liquid paraffin, white soft paraffin

e.g. Liquifilm®, Snotears®, Clinitas®, Hylo-tear®, Systane®

Haemorrhoid treatment for short term use 5-7 days

Anusol®, Germoloids®, Anodesyn and Preparation H; creams, gels, ointments and

suppositories

  
Head lice treatment

Dimeticone lotion/spray/ mousse/gel,

cyclomethicone solution/spray, malathion liquid,

permethrin liquid/spray

 
Herbal and complementary treatmentsHomeopathic preparations, bitters and tonics, herbal medicines, health supplements, probiotics (VSL#3®, Symprove®) 
Indigestion and heartburn (dyspepsia) treatmentAntacid and alginate tablets and mixtures e.g. Mucogel®, Rennie®, Peptobismol®, Gaviscon® 
Mouth ulcer treatmentBenzydamine and chlorhexidine mouthwashes/sprays, choline salicylate (Bonjela®), hydrocortisone buccal tablets 
Nappy rash treatmentMetanium®, Bepanthen® 
Scabies treatmentPermethrin liquid/cream 
Seasonal rhinitis (hayfever) treatmentSteroid nasal sprays, antihistamines, sodium cromoglycate eye drops 
Threadworm treatmentMebendazole tablet/suspension 
Topical steroid treatment for short term use, up to 1 week (insect bites/stings, contact dermatitis, nappy rash)Hydrocortisone 1% cream/ointment 
Vitamins and mineralsVitamin A, B, C, D, E, K, multivitamins, zinc, calcium and magnesium supplements 
Wart and verruca treatmentSalicylic acid preparations 

 

Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website