Background
Over-the-counter products can be bought without a prescription from a pharmacy.
- Some over-the-counter medications are only sold after discussion with the pharmacist, whereas other medicines can often be found in supermarkets or health stores.
- These types of items are for conditions which are self-limiting (i.e. a condition that resolves on its own, and has no long-term effects on health).
- NHS England advises these should be bought over the counter where possible, not prescribed, to support patients in self-care of minor ailments. It also saves the NHS approximately ÂŁ569 million annually which can be reinvested into other forms of care.
- Medication for Long Term Conditions
- Complex forms of minor illnesses
- Complex Patients
These patients should receive prescriptions instead
Difficult Conversations
Every year the local ICB expects us to reduce the spending on medication which doesn’t need a prescription to purchase, even if the patient is exempt from prescription charges or has a pre-payment certificate.
The following ideas may be useful during conversations when a patient is insistent that they should receive a prescription, even if they don’t meet the criteria:
- Pharmacy first scheme may give medication at no cost to the patient, if eligible
- Many items will be available from supermarkets, and high-street discount stores
- The issue is self-limiting, and medicine isn’t always necessary
Which Conditions Shouldn’t be Prescribed For?
If the condition is suitable for self-care or is self-limiting:
- Refer to the PrescQIPP Quick Reference Guide for advice to give, exceptions, examples of medications, and any OTC restrictions
- Signpost the patient to a local pharmacy, and provide appropriate self-care advice
- Alternatives for patients who aren’t able to or don’t want to go to local pharmacies include mobile apps or websites where medication can be ordered. For example: Healistic, Pharmacy2u, or Well are all solutions that work well locally and deliver medications directly to patients.
- Patients can be directed to nhs.uk or patient.co.uk
Conditions for which over the counter items should not routinely be prescribed:
As a general rule, if a medication can be bought OTC, then we should not be prescribing. Examples of these common medicines include:
- Vitamin D and other vitamins
- antihistamines
- Coughs and cold remedies
- Pain medication for acute symptoms
- emollients for dry skin
- eye drops for dry eyes - e.g Hylo-Tears, Hypromellose
During medication reviews, the pharmacist should be having these conversations with patients, taking the medication off repeat and directing them to their pharmacy/health store to purchase. Additionally, for certain patients who are exempt from prescription charges, they can get certain medications free of charge via the pharmacy first scheme.