NHS crackdown on silk garment prescriptions

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Image caption Silk garment prescriptions for people with eczema and dermatitis cost the health service in England more than £1.2m a year

NHS England has announced plans to curb the prescription of “low-priority” items like silk garments.

There is limited evidence the clothing helps people with eczema and dermatitis enough to justify prescribing it, a consultation document says.

Officials are proposing ending the routine prescription of eight items under plans aimed at saving £68m a year.

Others include an acne medication and diabetes products.

The items, which are deemed to be of relatively low clinical effectiveness or to have cheaper options available for funding, are:

  • Silk garments – for eczema and dermatitis (low clinical effectiveness)
  • Aliskiren – used to treat blood pressure (cheaper options available)
  • Amiodarone – to treat abnormal heart rhythms (low clinical effectiveness)
  • Bath and shower emollient preparations – to treat eczema and dermatitis (low clinical effectiveness)
  • Dronedarone – to treat the heart condition atrial fibrillation (low clinical effectiveness)
  • Minocycline – to treat acne (low clinical effectiveness)
  • Blood glucose testing strips – for type-2 diabetes (cheaper options available)
  • Needles for pre-filled and reusable insulin pens – for type-1 and type-2 diabetes (cheaper options available)

Many prescribers will not be surprised by the recommendations and have already started phasing out some of the items.

The health service in England spends more than £1.2m a year on prescriptions for silk garments, examples of which include silk baby bodysuits, infant leggings, children’s pyjamas, gloves or tubular sleeves.

In the case of the testing strips and needles, officials are proposing that GPs prescribe the cheaper versions of these products. It said there was a big variation in price, with strips ranging from £5 to £16 and needles costing between £4 and £30.

NHS England has already ordered an end to the routine prescribing of 18 low-value items, including homeopathy treatments and over-the-counter products such as paracetamol and cough medicines.

NHS England chief executive Simon Stevens said: “The NHS is one of the most efficient health services in the world but, as part of the long-term plan for the NHS, we’re determined to make taxpayers’ money go further and drive savings back into front-line care.

“It is essential the NHS should not be paying for anything which has been proven to be ineffective or where there are safer or cheaper alternatives.”

The consultation comes ahead of GPs being issued with new guidance next week on gluten-free prescriptions.

While patients can still receive bread and gluten-free baking mixes under NHS prescriptions, they are no longer eligible for other foodstuffs such as pizzas, cakes and biscuits, NHS England said.

Officials added that the NHS began funding gluten-free food products in the late 1960s, when availability was limited, but now a wide variety of foods is available in supermarkets.

The consultation will run for three months from 28 November 2018 until 28 February 2019, after which joint commissioning guidance is expected to be published by NHS England and NHS Clinical Commissioners.

The National Eczema Society said it was “vital for people with eczema to have access to the right emollient products on prescription”.

A spokesman added: “We look forward to participating in the consultation.”

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