Post by kickingfrog on Oct 21, 2011 8:34:46 GMT
**************
Prescription cuts
From Glutafin:
Find out more about why your may be told by your GP or pharmacist that you can no longer gain certain gluten free foods on your prescription.
Why are certain gluten free foods being restricted on prescription?
This is because the NHS is trying to reduce its costs and save money. Gluten free items being restricted in some areas include pasta, sweet biscuits and cake mix. Pasta is a staple food in the UK diet and Coeliac UK’s position is that staple foods such as bread (including fresh bread), pasta, flours, crisp breads and pizza bases listed for prescription should remain available.
It is felt that with sweet products such as cakes mixes and sweet biscuits it is difficult to argue for their continued existence on prescription in light of the health-eating messages from the government. In the case of cake mix and sweet biscuits Coeliac UK feels that this should no longer be available on prescription,
Whilst it is important to aim for a healthy, well-balanced diet it should be remembered that all foods are allowed in moderation and these foods can play an important role in the diets of some patients with coeliac disease where nutritional intake and status is of concern.
There are a number of multipurpose mixes available on prescription which can be used to make good-quality, gluten free cakes.
What is Glutafin doing about these gluten free prescription restrictions?
We are aware that some Primary Care Trusts (PCTs) are reviewing their policies on the prescribing of gluten free foods. Changes include restricting access to certain products and/or limiting the amount available. We share concerns about the impact of such policies on patients & their ability to comply with a nutritionally adequate gluten free diet.
In order to both verify & question this policy, we have turned to our Industry Group, the BSNA (British Specialist Nutrition Association) to act on our behalf.
The BSNA has held discussions with Coeliac UK & we are aware that Coeliac UK is contacting individual PCTs to take up the matter of restriction of gluten free products on prescription in order to ensure a fair outcome for coeliac patients.
What can I do about it?
We would suggest that in the first instance you contact Coeliac UK (0845 305 2060) to outline the following:
- Location of the restriction
- Who informed you of the restriction (i.e. GP. Pharmacist, PCT etc)
- What level of restriction is in place i.e. full or partial (if partial try to explain what is allowed)
- Was any rationale provided to explain the restriction (i.e. PCT decision, new pharmacy-prescribing scheme etc)
In addition, you could also look to contact your local dietitian and make them aware of the restriction in place.
If you have any concerns about prescribing in your area, or wish to know more about what is happening in your area, email prescriptions@coeliac.org.uk
www.glutafin.co.uk/news/restrictions-update/
***************
From Juvela
Prescription Update
Most people with coeliac disease understand the importance of sticking to a gluten-free diet and as the results of previous surveys have indicated this can be best achieved through the availability of staple foods on prescription. Therefore last month’s survey on prescription restrictions was really interesting and the results reflected both feedback we have received from Coeliac UK and calls to the Juvela advice line.
To summarise, the main changes you have reported back to us concern issues over the quantities and variety of products allowed on prescription. Perhaps understandably, with the increase in ‘treat’ products available in the supermarkets and the Department of Health’s focus on healthy eating, sweet biscuits and cake mixes are the ‘types’ of foods most widely restricted. However, a significant number of you reported that your choice of staple foods has been reduced including bread (particularly fresh), flour mixes and pasta.
The quantity issues you are experiencing are likely to be due to either your PCT or GP enforcing the nationally recognised guidelines for prescribed gluten-free foods. These guidelines, compiled by healthcare professionals and Coeliac UK, set out the minimum amount of gluten-free food that should be prescribed per individual, per month as units, based on nutritional recommendations consistent with your age and sex.
What is worrying to us is that a few of you have reported that you have been restricted to a set number of units regardless of your age, gender, lifestyle or nutritional requirements. If this is the case we would recommend that you arrange to discuss your concerns with your dietitian who can assess your food requirements or discuss with your GP as to whether the prescription is appropriate for your requirements.
We also acknowledge that many of you have experienced little or no changes to your prescription requirements, although some of you have mentioned the possibility of new schemes being introduced in the near future.
So why are these changes happening?
As part of the NHS review, the government is looking at all areas to improve efficiencies but at the same time trying to involve the patient more in their own care. This includes prescriptions and in particular over prescribing and explains why you may have experienced some restrictions with your gluten-free prescription.
Coeliac UK has recently completed a thorough review of PCT practices and has initiated action where appropriate to ensure the PCT is meeting the needs of their coeliac patients. The latest issue of Crossed Grain Magazine has an article which explains what the Charity is doing on your behalf to help secure the future of gluten-free prescribing in the NHS.
Juvela supports the charity’s new stance, recognising that the gluten-free prescription provides an essential foundation to help you manage your gluten-free diet.
Coeliac UK’s stance on prescriptions
- Gluten-free prescribing is an essential NHS Service that should be available to all patients.
- Staple foods such as breads (including fresh), pasta, flours, pizza bases and crackers listed by the ACBS should remain available and specialist breakfast cereals should be added.
- Cakes Mixes should no longer be available and sweet biscuits should be considered in exceptional circumstances on clinical advice.
- Amounts recommended in the guidelines should be treated as the norm.
What action can you take?
If you find that what you can get on prescription does not comply with the prescribing guidelines, or Coeliac UK’s stance on prescribing, you should first of all contact Coeliac UK: 0845 305 2060 or www.coeliac.org.uk
Other actions you may wish to take include:
- Contact your local PCT or PALS (Patient Advice and Liaison Service)
- Lobby your local MP and/or political representatives
- Link in with fellow coeliacs - we are aware that some of you are expressing your concerns through a petition
Further information on the importance of gluten free foods on prescription can be found on the BSNA website
www.juvela.co.uk/news/prescription-update
****************
Prescription restrictions – what we’re doing to help you
Prescription restrictions - what we're doing to help you
Over the past year Coeliac UK has been campaigning hard against prescription cuts across the UK. We have been in touch with over 50% of PCTs in England, plus Health Boards in Northern Ireland, Scotland and Wales in addition to a number of national bodies and policymakers to highlight the importance of gluten-freefoods on prescription for patients with coeliac disease.
Learn more about what we are doing to ensure gluten-free food on prescription stays within the NHS.
changes to gluten-free prescribing
Since the summer of 2010 we have heard from Members and healthcare professionals about changes to gluten-free prescribing in thier local area. As the NHS looks to drive down costs across the board, a number of Primary Care Trusts (PCTs) have placed strict limits on what can be prescribed for patients with coeliac disease. The main argument given by PCTs focuses on the cost of gluten-free foods on prescription to the NHS.
In most areas, changes focus on:
“luxury items” (sweet biscuits and cake mixes) being removed, often based on ‘Healthy Eating’ schemes
specific products being taken off the list of available products i.e. fresh bread
a new limit placed on the number of units allowed per month.
Coeliac UK’s position
Coeliac UK strongly believes that prescribing of gluten-free staple foods is an essential NHS service that should be available to all patients.
We feel that gluten-free food on prescription should stay within the NHS and are working hard to ensure that the view and needs of people with coeliac disease is represented.
Our postition calls for:
staple foods such as breads (including fresh bread), pasta, flours, crackers and pizza bases listed by the ACBS to remain available and specialist breakfast cereals should be added
cake mixes to no longer be available and sweet biscuits to only be considered in exceptional circumstance on clinical advice
amounts recommended in the guidelines to be treated as the norm
We support choice in the prescribing of gluten-free staple foods and ask PCTs to allow doctors and dietitians to use their clinical judgement when prescribing foods for an individual. Everyone’s lifestyle and preferences are different and this makes a “one size fits all” policy difficult.
More information can be found in the spring 2011 Crossed Grain article
Call for national dialogue - tackling high costs
When a manufacturer applies to have their product available on prescription, they need to have it approved by the Advisory Committee on Borderline Substances (ACBS). The ACBS will look at the type of product, its nutritional value and its cost. The cost covers both the cost of the product plus postage and packaging to get it from the factory to your pharmacy.
However, there are can be issues in the supply chain which lead to additional handling charges above and beyond that approved by the ACBS. This can be due to a range of different factors including:
the type of product
the amount of product in stock
the route it takes from factory to pharmacy.
Coeliac UK strongly believes that gluten-free foods on prescription are an essential NHS service. But, examples of high costs are driving NHS managers to conclude that gluten-free prescriptions need to be restricted to control budgets. We don’t agree with the high prices linked to delivery and handling and are calling for a national dialogue to ensure a fairer, more transparent system pricing system. for all.
To this end we have met with the All Party Parliamentary Group on coeliac disease and DHand Members of the Welsh Assembly. We are also in communication with the ACBS, the Department of Health, manufacturers, wholesales and national bodies representing pharmacies and other healthcare professionals.
We are promoting the revised 2004 guidlines on gluten-free prescribing and a Toolkit on pharmacy-led prescribing schemes at the national and local level. These highlight the important role of gluten-free prescribing in the treatment of coeliac disease and offer NHS managers an alternative way of handling gluten-free prescribing which empower patients, save GP time and drive down costs.
local campaigns - Taking up your concerns with PCTs and Health boards
Where you have contacted us about your PCT/Health Board restricting your prescription, we have followed up by contacting the PCT/Health Board directly so we can better understand the issues and support the case for people with coeliac disease with appropriate action. We have then followed this with a letter from Sarah Sleet, our Chief Executive reinforcing the Charity's position on prescribing of gluten-free foods.
Click here for a full list of the PCTs and Health Boards that we have been in touch with.
In a number of areas we have also met with NHS managers and Medicine Management teams. This includes:
Cardiff
East Sussex
Kent
Oxford
Stockport
Surrey
West Sussex
Wolverhampton
What do the PCTs say?
In the majority of places it is a good news story with PCTs and Health Boards either confirming that their policies are in line with Coeliac UK's positon on gluten-free prescribing, or reviewing their policies and bringing them back into line.
This is fantastic news and we are delighted that our interventions are making a difference. Thank you to all Members and healthcare professionals who have given us their help.
Looking forward however, in light of the current spending cuts within the NHS we know that NHS managers are keeping a very close eye on gluten-free prescribing. We are doing all we can to make sure that the welfare of people with coeliac disease is not affected by these actions.
TIGHTER RESTRICTIONS
There are a small number of PCTs where the policies being introduced are more restrictive. The most restrictive area is the South East Coast Alliance (covering Surrey, East Sussex, West Sussex and Kent) where only long-life bread and flour are being prescribed, but issues also continue in Stockport and the Wirral.
In these areas, alongside our formal conversations we have been working with Members, Local Voluntary Support Groups, national bodies, MPs and councilors to give ensure a loud voice in opposition to the cuts.
For more information on restrictions in Surrey, Sussex and Kent visit our South East Coast Alliance webpage.
What can you do
Please do keep us informed of developments within your local area. The easiest way to do this is by emailing prescriptions@coeliac.org.uk
Local activity is key here as it is local decision makers who are making policy and so this is the track you need to take if you want to have your voice heard. There are a number of ways you can campaign against prescripton cuts in your local area. For more information on how to get involved, email prescriptions@coeliac.org.uk
We have also been working with local media to spread the news. If you want to get involved with this simply complete the Prescription case study form and return to prescriptions@coeliac.org.uk.
We will be keeping all Members updated of developments in Crossed Grain and eXG. We will be providing regular updates on our work in this area, plus ways for you to support the Charity.
Presenting a united front
The issue of gluten-free prescribing is an incredibly tough topic to communicate, involving a large number of bodies – both in and out of the NHS. For this reason we are asking everybody to work with Coeliac UK, using the tools that we are developing, to ensure that we present a united front.
For more information on how to get involved, and to give your support prescriptions@coeliac.org.uk
www.coeliac.org.uk/gluten-free-diet-lifestyle/food-on-prescription/whatweredoingtohelp
********************
Prescription cuts
From Glutafin:
Find out more about why your may be told by your GP or pharmacist that you can no longer gain certain gluten free foods on your prescription.
Why are certain gluten free foods being restricted on prescription?
This is because the NHS is trying to reduce its costs and save money. Gluten free items being restricted in some areas include pasta, sweet biscuits and cake mix. Pasta is a staple food in the UK diet and Coeliac UK’s position is that staple foods such as bread (including fresh bread), pasta, flours, crisp breads and pizza bases listed for prescription should remain available.
It is felt that with sweet products such as cakes mixes and sweet biscuits it is difficult to argue for their continued existence on prescription in light of the health-eating messages from the government. In the case of cake mix and sweet biscuits Coeliac UK feels that this should no longer be available on prescription,
Whilst it is important to aim for a healthy, well-balanced diet it should be remembered that all foods are allowed in moderation and these foods can play an important role in the diets of some patients with coeliac disease where nutritional intake and status is of concern.
There are a number of multipurpose mixes available on prescription which can be used to make good-quality, gluten free cakes.
What is Glutafin doing about these gluten free prescription restrictions?
We are aware that some Primary Care Trusts (PCTs) are reviewing their policies on the prescribing of gluten free foods. Changes include restricting access to certain products and/or limiting the amount available. We share concerns about the impact of such policies on patients & their ability to comply with a nutritionally adequate gluten free diet.
In order to both verify & question this policy, we have turned to our Industry Group, the BSNA (British Specialist Nutrition Association) to act on our behalf.
The BSNA has held discussions with Coeliac UK & we are aware that Coeliac UK is contacting individual PCTs to take up the matter of restriction of gluten free products on prescription in order to ensure a fair outcome for coeliac patients.
What can I do about it?
We would suggest that in the first instance you contact Coeliac UK (0845 305 2060) to outline the following:
- Location of the restriction
- Who informed you of the restriction (i.e. GP. Pharmacist, PCT etc)
- What level of restriction is in place i.e. full or partial (if partial try to explain what is allowed)
- Was any rationale provided to explain the restriction (i.e. PCT decision, new pharmacy-prescribing scheme etc)
In addition, you could also look to contact your local dietitian and make them aware of the restriction in place.
If you have any concerns about prescribing in your area, or wish to know more about what is happening in your area, email prescriptions@coeliac.org.uk
www.glutafin.co.uk/news/restrictions-update/
***************
From Juvela
Prescription Update
Most people with coeliac disease understand the importance of sticking to a gluten-free diet and as the results of previous surveys have indicated this can be best achieved through the availability of staple foods on prescription. Therefore last month’s survey on prescription restrictions was really interesting and the results reflected both feedback we have received from Coeliac UK and calls to the Juvela advice line.
To summarise, the main changes you have reported back to us concern issues over the quantities and variety of products allowed on prescription. Perhaps understandably, with the increase in ‘treat’ products available in the supermarkets and the Department of Health’s focus on healthy eating, sweet biscuits and cake mixes are the ‘types’ of foods most widely restricted. However, a significant number of you reported that your choice of staple foods has been reduced including bread (particularly fresh), flour mixes and pasta.
The quantity issues you are experiencing are likely to be due to either your PCT or GP enforcing the nationally recognised guidelines for prescribed gluten-free foods. These guidelines, compiled by healthcare professionals and Coeliac UK, set out the minimum amount of gluten-free food that should be prescribed per individual, per month as units, based on nutritional recommendations consistent with your age and sex.
What is worrying to us is that a few of you have reported that you have been restricted to a set number of units regardless of your age, gender, lifestyle or nutritional requirements. If this is the case we would recommend that you arrange to discuss your concerns with your dietitian who can assess your food requirements or discuss with your GP as to whether the prescription is appropriate for your requirements.
We also acknowledge that many of you have experienced little or no changes to your prescription requirements, although some of you have mentioned the possibility of new schemes being introduced in the near future.
So why are these changes happening?
As part of the NHS review, the government is looking at all areas to improve efficiencies but at the same time trying to involve the patient more in their own care. This includes prescriptions and in particular over prescribing and explains why you may have experienced some restrictions with your gluten-free prescription.
Coeliac UK has recently completed a thorough review of PCT practices and has initiated action where appropriate to ensure the PCT is meeting the needs of their coeliac patients. The latest issue of Crossed Grain Magazine has an article which explains what the Charity is doing on your behalf to help secure the future of gluten-free prescribing in the NHS.
Juvela supports the charity’s new stance, recognising that the gluten-free prescription provides an essential foundation to help you manage your gluten-free diet.
Coeliac UK’s stance on prescriptions
- Gluten-free prescribing is an essential NHS Service that should be available to all patients.
- Staple foods such as breads (including fresh), pasta, flours, pizza bases and crackers listed by the ACBS should remain available and specialist breakfast cereals should be added.
- Cakes Mixes should no longer be available and sweet biscuits should be considered in exceptional circumstances on clinical advice.
- Amounts recommended in the guidelines should be treated as the norm.
What action can you take?
If you find that what you can get on prescription does not comply with the prescribing guidelines, or Coeliac UK’s stance on prescribing, you should first of all contact Coeliac UK: 0845 305 2060 or www.coeliac.org.uk
Other actions you may wish to take include:
- Contact your local PCT or PALS (Patient Advice and Liaison Service)
- Lobby your local MP and/or political representatives
- Link in with fellow coeliacs - we are aware that some of you are expressing your concerns through a petition
Further information on the importance of gluten free foods on prescription can be found on the BSNA website
www.juvela.co.uk/news/prescription-update
****************
Prescription restrictions – what we’re doing to help you
Prescription restrictions - what we're doing to help you
Over the past year Coeliac UK has been campaigning hard against prescription cuts across the UK. We have been in touch with over 50% of PCTs in England, plus Health Boards in Northern Ireland, Scotland and Wales in addition to a number of national bodies and policymakers to highlight the importance of gluten-freefoods on prescription for patients with coeliac disease.
Learn more about what we are doing to ensure gluten-free food on prescription stays within the NHS.
changes to gluten-free prescribing
Since the summer of 2010 we have heard from Members and healthcare professionals about changes to gluten-free prescribing in thier local area. As the NHS looks to drive down costs across the board, a number of Primary Care Trusts (PCTs) have placed strict limits on what can be prescribed for patients with coeliac disease. The main argument given by PCTs focuses on the cost of gluten-free foods on prescription to the NHS.
In most areas, changes focus on:
“luxury items” (sweet biscuits and cake mixes) being removed, often based on ‘Healthy Eating’ schemes
specific products being taken off the list of available products i.e. fresh bread
a new limit placed on the number of units allowed per month.
Coeliac UK’s position
Coeliac UK strongly believes that prescribing of gluten-free staple foods is an essential NHS service that should be available to all patients.
We feel that gluten-free food on prescription should stay within the NHS and are working hard to ensure that the view and needs of people with coeliac disease is represented.
Our postition calls for:
staple foods such as breads (including fresh bread), pasta, flours, crackers and pizza bases listed by the ACBS to remain available and specialist breakfast cereals should be added
cake mixes to no longer be available and sweet biscuits to only be considered in exceptional circumstance on clinical advice
amounts recommended in the guidelines to be treated as the norm
We support choice in the prescribing of gluten-free staple foods and ask PCTs to allow doctors and dietitians to use their clinical judgement when prescribing foods for an individual. Everyone’s lifestyle and preferences are different and this makes a “one size fits all” policy difficult.
More information can be found in the spring 2011 Crossed Grain article
Call for national dialogue - tackling high costs
When a manufacturer applies to have their product available on prescription, they need to have it approved by the Advisory Committee on Borderline Substances (ACBS). The ACBS will look at the type of product, its nutritional value and its cost. The cost covers both the cost of the product plus postage and packaging to get it from the factory to your pharmacy.
However, there are can be issues in the supply chain which lead to additional handling charges above and beyond that approved by the ACBS. This can be due to a range of different factors including:
the type of product
the amount of product in stock
the route it takes from factory to pharmacy.
Coeliac UK strongly believes that gluten-free foods on prescription are an essential NHS service. But, examples of high costs are driving NHS managers to conclude that gluten-free prescriptions need to be restricted to control budgets. We don’t agree with the high prices linked to delivery and handling and are calling for a national dialogue to ensure a fairer, more transparent system pricing system. for all.
To this end we have met with the All Party Parliamentary Group on coeliac disease and DHand Members of the Welsh Assembly. We are also in communication with the ACBS, the Department of Health, manufacturers, wholesales and national bodies representing pharmacies and other healthcare professionals.
We are promoting the revised 2004 guidlines on gluten-free prescribing and a Toolkit on pharmacy-led prescribing schemes at the national and local level. These highlight the important role of gluten-free prescribing in the treatment of coeliac disease and offer NHS managers an alternative way of handling gluten-free prescribing which empower patients, save GP time and drive down costs.
local campaigns - Taking up your concerns with PCTs and Health boards
Where you have contacted us about your PCT/Health Board restricting your prescription, we have followed up by contacting the PCT/Health Board directly so we can better understand the issues and support the case for people with coeliac disease with appropriate action. We have then followed this with a letter from Sarah Sleet, our Chief Executive reinforcing the Charity's position on prescribing of gluten-free foods.
Click here for a full list of the PCTs and Health Boards that we have been in touch with.
In a number of areas we have also met with NHS managers and Medicine Management teams. This includes:
Cardiff
East Sussex
Kent
Oxford
Stockport
Surrey
West Sussex
Wolverhampton
What do the PCTs say?
In the majority of places it is a good news story with PCTs and Health Boards either confirming that their policies are in line with Coeliac UK's positon on gluten-free prescribing, or reviewing their policies and bringing them back into line.
This is fantastic news and we are delighted that our interventions are making a difference. Thank you to all Members and healthcare professionals who have given us their help.
Looking forward however, in light of the current spending cuts within the NHS we know that NHS managers are keeping a very close eye on gluten-free prescribing. We are doing all we can to make sure that the welfare of people with coeliac disease is not affected by these actions.
TIGHTER RESTRICTIONS
There are a small number of PCTs where the policies being introduced are more restrictive. The most restrictive area is the South East Coast Alliance (covering Surrey, East Sussex, West Sussex and Kent) where only long-life bread and flour are being prescribed, but issues also continue in Stockport and the Wirral.
In these areas, alongside our formal conversations we have been working with Members, Local Voluntary Support Groups, national bodies, MPs and councilors to give ensure a loud voice in opposition to the cuts.
For more information on restrictions in Surrey, Sussex and Kent visit our South East Coast Alliance webpage.
What can you do
Please do keep us informed of developments within your local area. The easiest way to do this is by emailing prescriptions@coeliac.org.uk
Local activity is key here as it is local decision makers who are making policy and so this is the track you need to take if you want to have your voice heard. There are a number of ways you can campaign against prescripton cuts in your local area. For more information on how to get involved, email prescriptions@coeliac.org.uk
We have also been working with local media to spread the news. If you want to get involved with this simply complete the Prescription case study form and return to prescriptions@coeliac.org.uk.
We will be keeping all Members updated of developments in Crossed Grain and eXG. We will be providing regular updates on our work in this area, plus ways for you to support the Charity.
Presenting a united front
The issue of gluten-free prescribing is an incredibly tough topic to communicate, involving a large number of bodies – both in and out of the NHS. For this reason we are asking everybody to work with Coeliac UK, using the tools that we are developing, to ensure that we present a united front.
For more information on how to get involved, and to give your support prescriptions@coeliac.org.uk
www.coeliac.org.uk/gluten-free-diet-lifestyle/food-on-prescription/whatweredoingtohelp
********************