Over the counter medication

NHS England published new prescribing guidance (29 March 2018) which covers 35 minor, short-term health conditions, which are either ‘self-limiting’ or suitable for ‘self-care’.

Self-care can be described as:

  • a self-limiting condition does not require any medical advice or treatment as it will clear up on its own, such as sore throats, coughs, colds and viruses
  • a minor illness that is suitable for self-care can be treated with items that can be purchased over the counter from a pharmacy. These conditions include, for example, indigestion, mouth ulcers and warts.

The new guidance recommends that medicines that are available over the counter should no longer be routinely prescribed for 35 minor, short-term conditions.  Vitamins, minerals and probiotics are also included in the restrictions as items of limited clinical effectiveness.

The NHS has been spending around £136 million a year on prescriptions for medicines that can be bought from a pharmacy or supermarket, such as paracetamol. By reducing the amount the NHS spends on over the counter medicines, we can give priority to treatments for people with more serious conditions, such as cancer, diabetes and mental health problems.

These changes will benefit patients by freeing up valuable GP time and promoting self-care for patients through community pharmacy services. Find your local pharmacy here

Find out more about this change to prescription policy.

More information can also be found on the NHS website here.

  • Pharmacists have the knowledge and skills to help with many healthcare conditions.
  • You don’t need an appointment.
  • Visiting a pharmacist first helps to make more GP appointments available for people with more complex healthcare needs.
  • If your condition is more serious, the pharmacist is trained to signpost you quickly to the right medical care

 

  • The new guidance will apply to everyone who is not covered by the general or condition-specific exceptions listed in the guidance.
  • The guidance does not apply to people with long-term or more complex conditions who will continue to get their usual prescriptions.
  • People who receive free prescriptions will not automatically be exempt from the guidance.
  • For patients where the clinician considers that their ability to self-manage is compromised as a consequence of medical, mental health or significant social vulnerability; these patients will continue to receive prescriptions for over the counter items subject to the item being clinically effective.
  • For the self-limiting conditions, where symptom relief may be required, the general exceptions will only apply where the prescription is for an over the counter item that is clinically effective
  • For vitamins, minerals and probiotics, only the condition-specific exceptions will apply.

 

Self-limiting illnesses:

  • Acute sore throat
  • Infrequent cold sores of the lip 
  • Conjunctivitis  
  • Coughs, colds and nasal congestion
  • Cradle Cap (Seborrhoeic dermatitis – infants)
  • Haemorrhoids
  • Infant colic
  • Mild cystitis

Minor illnesses suitable for self-care:

  • Mild irritant dermatitis
  • Dandruff
  • Diarrhoea (adults)
  • Dry eyes/sore (tired) eyes
  • Earwax
  • Excessive sweating (hyperhidrosis)
  • Head lice
  • Indigestion and heartburn
  • Infrequent constipation
  • Infrequent migraine
  • Insect bites and stings
  • Mild acne
  • Mild dry skin
  • Sunburn
  • Sunburn protection
  • Mild to moderate hay fever/seasonal rhinitis
  • Minor burns and scalds
  • Minor conditions associated with pain, discomfort and/fever (e.g. aches and sprains, headache, period pain, back pain)
  • Mouth ulcers  
  • Nappy rash
  • Oral thrush    
  • Prevention of tooth decay or cavities
  • Ringworm/athletes foot
  • Teething/mild toothache
  • Threadworms
  • Travel sickness
  • Warts and verrucae  

Items of limited clinical effectiveness:

  • Probiotics
  • Vitamins and minerals.

You may still be prescribed a medicine for a condition on the list if:

  • You need treatment for a long-term condition, e.g. regular pain relief for chronic arthritis or inflammatory bowel disease.
  • You need treatment for more complex forms of minor illnesses, e.g. migraines that are very bad and where over the counter medicines do not work.
  • You need an over the counter medicine to treat a side effect of a prescription medicine or symptom of another illness, e.g. constipation when taking certain painkillers.
  • The medicine has a licence which doesn’t allow the product to be sold over the counter to certain groups of patients. This could include babies, children or women who are pregnant or breast-feeding.
  • The person prescribing thinks that a patient cannot treat themselves, for example because of mental health problems or severe social vulnerability.

Keeping a few useful medicines at home means you can treat common conditions immediately without needing to see a healthcare professional. These could include:

  • Painkillers to help with pain, discomfort and fever
  • Indigestion medicines, oral rehydration salts and treatments for constipation and diarrhoea
  • Treatments for seasonal conditions like colds and hay fever
  • Sunblock and after sun
  • Basic first aid items (for example plasters or antiseptic cream)

If you have children, make sure you also have products suitable for them. Speak to your local pharmacy team about what medicines to keep at home, where to store them safely and how to use them.

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  • Over the counter medication: Patient Leaflet

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