Gluten-free prescribing

We would like to thank everyone for their contributions to this consultation. The feedback from the consultation was considered individually and every contribution was used to compile a consultation report so that the CCG could carefully consider the feedback we received before making any decision. The final decision was announced at the CCG's Governing Body meeting on 10 February 2016.  The decision that the Governing Body made is explained below.

Decision of the Governing Body

Following the consultation the Governing Body decided that GPs should be recommended and supported to stop gluten free prescribing. This prescribing advice was issued to GPs who will work with coeliac patients to discuss how they can best manage their condition and develop an individual care plan. This is the same approach that the NHS takes for all patients with long-term conditions. Patients will continue to receive high quality clinical care. This revision to prescribing will take effect from 12 February 2016.

About this closed consultation (30 November 2015 - 18 December 2015)

NHS Enfield Clinical Commissioning Group (CCG) considered a change to gluten-free prescribing as part of its Transformation Programme. The Medicines Management Committee carried out a review of treatments that were shown to be less clinically effective, provide insufficient health benefits and those that do not represent good value for money.

The CCG was spending over £100,000 each year on prescriptions for gluten-free foods for people with coeliac disease. The NHS does not provide food on prescription for other groups of patients whose diseases are associated with, or affected by, the type of food they eat. Gluten-free prescribing started over 30 years ago. Then gluten-free foods were not easily available to buy in the shops so were offered on prescription to help coeliacs manage their diet. Now gluten-free alternatives are widely available at much cheaper prices and due to changing diets and lifestyle choices, there is also a much wider variety of foods available in the shops and supermarkets.

Because of the availability of gluten-free alternatives, the variety of foods now easily available and the equity issues of only prescribing food to coeliac patients, the CCG identified this as a potential area of disinvestment. Proposals to stop funding gluten-free prescribing on the NHS are being explored by many other CCGs across England.

Views were sought from patients, people with coeliac disease, GPs, clinicians, dieticians and other health professionals. We also did an equality impact assessment to look at how our proposals might affect patients.

You can read our consultation document which includes a questionnaire (now closed).