Escalating our challenge on gluten free prescribing in Somerset
In October 2016, Somerset CCG announced a policy change which proposed a blanket ban on gluten free prescribing. The ‘Frequently Asked Questions’ issued by the CCG made it clear there were to be no exceptions to the policy. For example, in one question they cite the case of people with dementia or learning difficulties who may have problems with access and asked if prescriptions could be issued – and their answer was no.
It was the explicit nature of this guidance that gave the charity a clear legal platform to challenge the CCG’s policy. The timing of this decision also meant that it was made after the publication of the National Institute of Health and Care Excellence (NICE) quality standard which highlights the high cost of gluten free staple foods and the disproportionate impact that this may have on the most vulnerable patients.
The law is quite clear – although CCGs can set policies on prescribing they can only be guidance and that GPs retain the right to prescribe in the patient’s best interest, although they must take account of the CCG policies.
Because of this, we made the decision to seek legal advice on Somerset CCG’s actions and our solicitors agreed that there was the potential to challenge the CCG’s decision, given its acknowledgement of impact on the vulnerable and with no provision made to support those whose health would be at risk because of the removal of support. You can download a copy of the letter by downloading it from the right hand side of this page.
We are pleased to report that our legal challenge has worked and we have made Somerset CCG legally recognise their duty of care. In circumstances where health would be at risk, they have agreed to reissue guidance making it clear to GPs that they are legally able to prescribe gluten free foods where there is an individual health need. It is up to the patient to make the case so, while this isn’t a reinstatement of gluten free prescriptions for all, it means there is some safety net for those who need it the most.
We will now use the result to challenge other CCGs to make clear that GPs need to consider the patient need first and foremost.
If you are affected
We would like to stress that the final decision about what to prescribe lies with the GP and we would encourage individuals affected to have a discussion with their GP about gluten-free food on prescription if there are concerns about the impact of this move.
We understand the importance of access to gluten-free food on prescription for people with coeliac disease, particularly in view of the higher cost of gluten-free food in supermarkets and limited availability in small convenience stores which do not stock staple gluten-free foods. We are concerned that the measures taken by the CCG to save money will affect people’s ability to stick to the gluten-free diet.
If you would like to join us in opposing the prescription cuts, there are several things that you can do:
- Contact the local Healthwatch by emailing (firstname.lastname@example.org), calling on 01823 751 403 or writing to Healthwatch Somerset, c/o Somerset Rural Youth Project, Unit 2 Suprema Estate, Edington, Bridgwater, TA7 9LF
- Contact Somerset CCG by email (email@example.com) or write to: Somerset Clinical Commissioning Group, Wynford House, Lufton Way, Yeovil, Somerset, BA22 8HR
- Write to your local MP, we have a sample letter on our website (www.coeliac.org.uk/prescriptioncampaign) which you can use, or please feel free to write your own letter explaining how the changes will affect you
- Speak with your local GP about your individual case
- Watch out for more information on next campaign steps particularly on our website
As part of our work in opposing prescription cuts, we are looking for people affected by these prescription cuts to act as case studies. This will enable us to give examples to the media of how this policy change has affected people with coeliac disease. To become a case study or to find out more about interview opportunities and how to share your experience please call us on 0333 332 2033.