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 link below.
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.
To find out more about Somerset CCG’s proposal, our challenge and how you can get involved, visit our prescriptions policy page. You can also read a transcript of the letter. If you have any queries please contact us on our Helpline on 0333 332 2033.