Agenda item

Gail Arnold (Chief Operating Officer, NHS West Kent CCG) and Priscilla Kankam (Lead Pharmacist, NHS West Kent CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Ms Kankam began by explaining that NHS West Kent CCG was looking to stop the routine prescribing of gluten free items as part of its review into cost effective prescribing. She noted that the CCG spent £130,000 on gluten free products for 300 patients a year in West Kent with coeliac disease.  Patients with other conditions which required specialist diets such as diabetes and renal failure were not prescribed food items. She reported that when gluten free items on prescription were introduced, the availability of these items was low; now there were readily available in supermarkets and a loaf of gluten free bread cost £1.60 in Asda, Tesco & Waitrose. The cost to the NHS for a loaf of gluten free bread would be £4 - £10 which included the cost of the product, dispensing fee and delivery charge. She noted that there was a small group of patients who could only have a low protein food and those patients would be allowed to be prescribed low protein products as part of the proposals. She stated that the CCG had consulted its GPs and Governing Body and a public consultation would begin on 29 November to inform the public about the issue.

(2)       Members enquired about the availability of gluten free prescriptions nationally and if there was an advisory committee which provided guidance about the prescription of gluten free items. Ms Arnold stated that it was technically down to each individual GP to prescribe. Ms Kankam advised that there were lots of other gluten free products available which did not require a prescription such as potato and rice. Ms Arnold reported that there was an advisory committee which looked at the clinical conditions for gluten intolerance but did not have a role in providing guidance or criteria about prescriptions. Mr Inett commented that this change would most impact those who received free prescriptions, due to being on benefits or a low income; a loaf of gluten free bread which cost £1.40, in comparison to a normal loaf which cost 40p, would be unaffordable.

(3)       There was a discussion by Members about whether this constituted a substantial variation of service. The Scrutiny Research Officer advised the Committee that there was not a definition or criteria for substantial variation of service set out in the regulations and if the Committee did determine the proposal to be substantial, a period of formal consultation between the Committee and the CCG would start. If the CCG went ahead with the proposals but the Committee did not think that the proposals were in the best interests of the local people, the Committee could make a referral to the Secretary of State for Health. The Scrutiny Research Officer noted that there were separate duties on the NHS to consult with the Committee and the public and if the Committee did determine the proposals to be substantial, the decision to consult with the public was with the CCG and not for the HOSC to determine.

 (4)      RESOLVED that:

(a)       the Committee deems the withdrawal of gluten free prescriptions by NHS West Kent CCG to be a substantial variation of service.

(b)       West Kent CCG be invited to attend a meeting of the Committee in two months.