Changes to how the NHS prescribes ‘over the counter’ medicines for minor health conditions

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In March 2018, NHS England published guidance about reducing the prescribing of medicines or treatments that are available to buy over the counter.

This means that certain medicines may no longer be prescribed if you can buy them over the counter. The following will explain the changes, why they are happening and where you can get more information and support.

Medicines available to buy over the counter will not be routinely prescribed for the following 35 conditions:
• acute sore throat
• conjunctivitis
• coughs, colds and nasal congestion
• cradle cap
• dandruff
• diarrhoea (adults)
• dry eyes or sore tired eyes
• earwax
• excessive sweating
• haemorrhoids
• head lice
• indigestion and heartburn
• infant colic
• infrequent cold sores of the lip
• infrequent constipation
• infrequent migraine
• insect bites and stings
• mild acne
• minor burns and scalds
• mild cystitis
• mild dry skin
• mild irritant dermatitis
• mild to moderate hay fever
• minor conditions associated with pain, discomfort and fever (such as aches and sprains, headache, period pain, back pain)
• mouth ulcers
• nappy rash
• oral thrush
• prevention of tooth decay
• ringworm or athletes foot
• sunburn
• sun protection
• teething and mild toothache
• threadworms
• travel sickness
• warts and verrucae

Probiotics, and some vitamins and minerals will also no longer be routinely prescribed, because most people can, and should get these from eating a healthy, varied and balanced diet. Details about healthy eating is available on the NHS website.

In special cases some people will still be able to get prescriptions for the conditions (or medicines used to treat them) from the list above.
The NHS has to make difficult choices about what it spends taxpayer money on and how much value the taxpayer is getting for that money. Medicines to treat these conditions are available to buy over the counter. Pharmacists can advise patients on self-care and also on which are the lowest cost versions of medicines available.

By reducing the amount the NHS spends on treating these minor health conditions, the NHS can give priority to treatments for patients with more serious conditions such as cancer and mental health problems.
Pharmacists are trained clinicians who have the knowledge and skills to help with many healthcare conditions, and you don’t need an appointment to speak to a pharmacist. Visiting a pharmacist first helps to make more GP appointments available for people with more complex healthcare needs.

If you have something more serious, the pharmacist is trained to signpost you quickly to the right medical care.

What can you do?

By keeping certain useful medicines at home, you can treat common conditions immediately and you won’t need to see a GP. The medicines you may want to keep at home could include:

  • a painkiller to help treat minor conditions associated with pain, discomfort and fever
  • indigestion medicines, oral rehydration salts and treatments for constipation and diarrhoea
  • treatments for seasonal conditions such as colds and hay fever
  • sunblock and after sun
  • some basic first aid items would also be useful

If you have children make sure you also have products suitable for children.

Speak to your pharmacist for advice on what medicines to keep at home, where to store them safely and how to use your medicines.

Ensuring you have a well-balanced, healthy diet will mean most people don’t need to take vitamin supplements or probiotics. If you do wish to take these products to avoid you becoming deficient, you can buy them from a pharmacy, a supermarket or online.

Some individual patients may still be prescribed a medicine for a condition on the list. The reasons vary for each condition and GPs, nurses or clinical pharmacists will speak to you individually if this affects you. The main reasons are:

• treatment for a long-term condition, for example regular pain relief for chronic arthritis or inflammatory bowel disease
• treatment of more complex forms of minor illnesses, for example migraines that are very bad and where over the counter medicines do not work
• patients prescribed over the counter medicines to treat a side effect of a prescription medicine or symptom of another illness, for example, constipation when taking certain painkillers
• the medicine has a licence which doesn’t allow the product to be sold over the counter to certain groups of patients. This may vary by medicine, but could include babies, children or women who are pregnant or breast-feeding
• the prescriber thinks that a patient cannot treat themselves, for example because of mental health problems or severe social vulnerability (not just having a low income)
Your pharmacist can advise on how long you can expect to experience symptoms for the conditions listed. If your symptoms have not improved after this time or you start to feel a lot worse, contact your GP or call 111. The emergency department and 999 should only be used for life threatening emergencies. There is lots of advice on the NHS choices website to help you choose the right service.

Further Information & Support

  • You can speak to a pharmacist who can help with advice and treatments for the conditions listed
  • NHS choices has lots of information and advice on treating minor health problems with self-care
  • Find out more about the conditions for which over the counter medicines should no longer be prescribed on the NHS England website

If you have any questions about the items which are no longer going to be prescribed, then please email them to: kccg.contactus@nhs.net.