The time has come for doctors to stop prescribing gluten free foods to patients allergic to wheat gluten – known as coeliac disease – and for the NHS to find a better way to support patients, says an editorial in the independent review of medical treatment, the Drug and Therapeutics Bulletin (DTB).
The process is outmoded and costly, argues DTB. And what’s more, it’s adding a layer of unnecessary red tape to the NHS, which takes up healthcare professionals’ time and is unhelpful to patients.
NHS prescriptions for gluten free foods, such as bread and flour were introduced in the late 1960s, when access to these foods was considerably more limited than it is now, says DTB.
These foods are now readily available from supermarkets and other outlets, yet many people with coeliac disease are still requesting prescriptions to take them to a pharmacy to obtain their supplies.
This costs the NHS in England £27 million a year (2011), and with growing pressure on NHS budgets, it is right to question this arrangement, says DTB. Nevertheless, these foods can be up to 500% more expensive than their gluten containing equivalents, so some level of support should still be in place, it argues- just not via the costly and unwieldy route of family doctor prescriptions.
Furthermore, whether patients should be obtaining gluten free cakes/cake mixes or sweet biscuits on prescription is questionable in terms of their overall health, it argues.
While some attempts have been made to improve access to these foods and free up family doctor time, by introducing direct supply schemes at community pharmacies, that still leaves the process under the control of a healthcare professional, it says.
Is this really necessary or in patients’ best interests it asks?
“Is it time to consider the use of food vouchers that could be redeemed against gluten-free foods at any outlet, or the provision of personalised budgets for people with coeliac disease, so that the supply of food would no longer be a medical issue?”
And it concludes: “We would urge commissioners to consider redesigning services to ensure that there is ongoing support for people with coeliac disease and to remove the bureaucratic process of prescribing food from primary care.”
Prescribing food? Drug and Therapeutics Bulletin Vol 51, No 2 February 2013