Wasted or unused medicine is a serious and growing problem within the NHS. It has been estimated that £300 million of NHS prescribed medicines are wasted each year. This could otherwise pay for either:
- 11,778 more community nurses or
- 80,906 more hip replacements or
- 19,799 more drug treatment courses for breast cancer or
- 300,000 more drug treatment courses for Alzheimer's or
- 312,175 more cataract operations.
Reducing waste is everyone’s responsibility. The following resources are available to help reduce medicines waste:
Items which should not routinely be prescribed in primary care
After a national consultation, NHS England has taken action to reduce the prescribing of 18 inappropriate medicines which are deemed to be of limited value.
The 18 inappropriate medicines products reviewed as part of the NHS England consultation fall into one or more of the following categories:
- Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness, or there are significant safety concerns
- Products which are clinically effective but where more cost effective products are available, including some products that have been subject to excessive price inflation
- Products which are clinically effective but due to the nature of the product are deemed a low priority for NHS funding.
In the majority of cases there are other more effective and/or cheaper alternatives available to the treatments that NHS England is recommending should not be routinely prescribed in primary care. Please click on the links below for patient information leaflet on each medicine. Read NHS Waltham Forest CCG's Position statement for NHS England: Items which should not routinely be prescribed in primary care here.
- Glucosamine and chondroitin
- Herbal treatments
- Homeopathic remedy
- Immediate release fentanyl
- Lidocaine plasters
- Lutein and antioxidants
- Omega-3 fatty acid compounds
- Once daily Tadalafil
- Oxycodone and naloxone combination product
- Paracetamol and tramadol combination product
- Perindopril arginine
- Prolonged release doxazosin
- Rubifacients [excluding topical non-steroidal anti-inflammatory drugs (NSAIDs)]
- Vaccines administered exclusively for the purposes of travel
Conditions for which Over the Counter (OTC) medicines should not be prescribed
NHS England published its final guidance in March 2018 for CCGs following a public consultation on the prescribing of Over the Counter (OTC) medicines. It is estimated that this new guidance could release as much as £136 million each year to reinvest in other services.
The new over the counter medicines guidance will curb the routine prescribing of products that are for:
- Items of limited clinical effectiveness, such as probiotics, vitamins and minerals
- A self-limiting condition, which does not require any medical advice or treatment as it will clear up on its own, such as sore throats, coughs and colds
- A condition that is suitable for self-care, which can be treated with items that can easily be purchased over the counter from a pharmacy, such as indigestion, mouth ulcers, warts and verrucae.
Exceptions to the guidance apply to people with long-term conditions, and to patients who the prescriber considers unable to self-care due to medical, mental health or social vulnerability.
For more information on OTC see the the links below:
- NHS Waltham Forest CCG position statement
- NHS England guidance to CCGs: Conditions for which over the counter products should not be prescribed in Primary Care
- NHS England: Frequently asked questions for conditions where over the counter items should not routinely be prescribed in primary care
- NHS England: Prescribing of over the counter medicines is changing (patient information leaflet)
- NHS England: Over the counter guidance (patient information).