Food on prescription

What foods are available on prescription?

There are a wide variety of products now available from a variety of different manufacturers. Foods available vary but can include specially manufactured breads, rolls, pastas, flour and bread mixes, pizza bases, crackers and oats.

Try as many different products as you can because everyone's personal taste is different. You can also contact manufacturers directly and they will give you information on the range of products that they make and are usually happy to send out samples.

A list of all the foods available on prescription can be found in our Food and Drink DirectoryCoeliac UK’s key source of information listing thousands of foods that can be included in a gluten-free diet. , and can also be downloaded. New products become available throughout the year, which are added to this list and to our monthly updates for the Food and Drink Directory.

Who decides what products are available on prescription?

The Advisory Committee on Borderline Substances (ACBSThe Advisory Committee of Borderline Substances is responsible for deciding what products go onto the presciptions list. ), which is an independent body advising the Department of Health, approve a list of products like foods and supplements that can be prescribed to patients. It is these gluten-freeWhen a food has less than 20 parts per million (ppm) of gluten so it is safe for people with coeliac disease to eat. products, approved by the ACBS, that can be found in the Food and Drink Directory.

Although most GPsGeneral Practitioner, or local doctor will only prescribe products approved by the ACBS, they are able to prescribe alternatives if they believe it is needed for your care

You can find further information on the ACBS website.

How do I get food on prescription?

In most parts of the country, as with prescriptions for medication, your GP raises and signs the prescription which is then dispensed by a pharmacist. Once you are comfortable with the glutenA protein that is found in the cereals wheat, barley and rye. -free diet you will be able to get products on a repeat prescription.

Pharmacy-led Prescribing Schemes

Some primary care trusts (PCTs), such as Northamptonshire and Allerdale, Cumbria, run pharmacy-led prescribing schemes. These allow you to get gluten-free products directly from your local pharmacist instead of having to go through your GP. These schemes aim to free up GP time and provide easier access to gluten-free foods.

If your PCT now uses one of these schemes, it is important that you speak to your GP if your symptoms change or if you have any concerns. They can then refer you to a dietitianAn expert in food and nutrition. if necessary.

Coeliac UK is working with pharmacy organisations to look at the benefits of these schemes and encourage other PCTs to take them up.

How many items can I receive?

The amount of food that can be prescribed is up to your GP. However, there are guidelines available that recommend the amount of food you can receive on prescription each month. These guidelines are based on your age, gender and whether you are pregnant or breast-feeding.

The guidelines recommend a number of units each month which relate to a certain number of food items.

Table: Recommended amounts per month

Table: Number of units for different foods

The guidelines give flexibility about how you use your units. Some people may just receive bread on prescription, whilst others get a variety of foods.

To give you an idea of how a prescription could be made up, here is an example of a monthly prescription:

Male aged 15-59 years requires 18 units per month.

This could be made up of:

Will I need to pay for my prescription?

Prescriptions for gluten-free food are not free of charge unless you qualify for free prescriptions. To find out if you are entitled to free prescriptions, please see the NHS website.

The amount you pay for prescriptions varies between GPs but usually you will need to pay one prescription charge for each line on your prescription. The prescription charge in England is £7.85.

A pre-payment certificate may be cheaper

If you pay for prescription items, it may work out cheaper to get a pre-payment certificate (PPC) which allows you to pay a set fee for either 3 months or 12 months. If you think you will have to pay for 3 or more items in 3 months or more than 13 items in 12 months, a PPC will work out cheaper than paying for individual prescriptions. A PPC costs £29.10 for three months or £104 for 12 months.

A PPC covers you for all of your NHS prescription costs, no matter how many you need. For more information on savings using a PPC and the PPC application form please visit NHS website or speak to your local pharmacist or GP.

Can I change my prescription?

While you are getting used to your gluten-free diet, it is likely that you will want to change the amount or type of foods you get on prescription. If you want to change your prescription at any time you should make an appointment to see your GP.

Who can advise me on what products to choose?

If you are unsure about which products to order on prescription, your dietitian will be able to give you advice on what foods are best nutritionally. If you are newly diagnosed with coeliac diseaseA condition where a person is unable to eat gluten as it makes their body attack itself. check that you have been referred to a dietitian. Your GP or hospital doctor can arrange a referral.

What can I do if I have difficulty getting items on prescription?

The types of food available across the country will vary and not all products on the ACBS lists will be available in all PCTs. Some PCTs have been reviewing their policies on gluten-free prescribing due to the tough economic situation and healthy eating initiatives. This may have resulted in changes to your usual prescription.

Coeliac UK feels strongly that gluten-free prescribing is an essential NHS service that should be available to all patients.

We feel that the numbers of units recommended in the guidelines above should be treated as the norm and should only be exceeded in exceptional circumstances for clinical reasons e.g. if you are underweight or unable to meet your nutritional requirements.

We also recognise that there is a need for a review of the ACBS approved list with more of a focus on staple foods, nutritional composition and ethnic diversity. Staple foods such as breads (including fresh bread), pasta, flour, crackers and crispbread listed by the ACBS should remain available.

We cannot make a special case of support for prescribing biscuits and cake mixes. They are not staple foods and their use is not consistent with healthy eating recommendations.

If you take a copy of the prescribable list to your GP you can discuss with them which items are available to you.

If you are finding it difficult on the gluten-free diet we would recommend speaking to your local dietitian for individual support.

Further information on what Coeliac UK are doing on your behalf can be found in the Spring 2011 Crossed Grain magazine. Also, further information on the PCTs we have been in contact with can be found our website.