Decommissioning of gluten free prescriptions for adult patients in Scarborough and Ryedale

From 1 April 2017, NHS Scarborough and Ryedale Clinical Commissioning Group (CCG) no longer supports the prescribing of gluten free products to adult patients.

New guidance reflects the changes.

In 2015, the NHS spent £26 million on prescribing gluten free food with £16.7 million spent on 840,000 prescriptions for bread. The current cost of prescribing gluten free products in Scarborough and Ryedale is around £60,000 a year.

The decision to withdraw support for gluten free prescriptions for patients aged 18 and over follows an engagement exercise carried out by the CCG, which resulted in detailed feedback from Coeliac UK and the British Society of Gastroenterology. The CCG also took into consideration the 89 responses to an online survey and 17 responses gathered through face-to-face engagement, more than half of which were from coeliac sufferers.

Dr Greg Black, Governing Body member and Prescribing Lead for the CCG, said: “We would like to thank everyone who responded to the CCG survey and in particularly Coeliac UK who helped ensure the voices of local people with coeliac disease were heard.

“Having taken into consideration all of the feedback we received, along with the evidence available to us, we took the decision to stop prescribing gluten free products to adult patients, mainly due to the significant increase in the quality, variety and availability of gluten free products in supermarkets and via home delivery services.

“We also recognised that the NHS does not provide food on prescription for other groups of patients who have conditions which might be affected by the type of food they eat.

“While we know this decision will not be popular among patients who currently receive gluten free foods on prescription, the CCG’s duty is to manage budgets effectively and take commissioning decisions on behalf of the whole population in our area.”

The CCG will continue to support the prescribing of a small range of gluten free food products to those aged under 18, who have a confirmed coeliac disease diagnosis.

The gluten free products that can be prescribed to those under the age of 18 are:

• Bread (loaves only – not rolls, wraps or other bread products)
• Flour (not flour mix or bread mix)
• Pasta

If a patient has been diagnosed with coeliac disease, they must continue to follow a strict gluten free diet. The CCG recommends patients stick to foods that are naturally gluten free rather than specialist products that have been manufactured to be gluten free. Rice and potatoes are examples of foods that are naturally gluten free that can also be cheap to purchase. It remains important to have a well-balanced diet.

Coeliac UK produces a helpful food and drink directory, which is available free to members (or £10 to non-members). Following the Eatwell Plate model for balanced eating will provide a gluten free diet without need for any specialist dietary foods. This encourages choosing naturally gluten free carbohydrate containing foods as part of a healthy, balanced diet.

Coeliac UK provides useful information on all aspects of the disease, including a directory of gluten free foods and drinks: www.coeliac.org.uk

The NHS website also has useful information about coeliac disease and treatment: www.nhs.uk/Conditions/Coeliac-disease/Pages/Treatment.aspx