During the summer of 2018 patients in East Leicestershire and Rutland were asked for their views on changes to the prescribing of over the counter medicines.
The changes mean GPs will no longer provide prescriptions for medications and treatments which are available to buy over the counter at pharmacies and supermarkets and GPs, nurses and pharmacists will not routinely prescribe certain medicines for some minor health concerns.
ELR CCG’s activities involved engagement rather than a public consultation because, following its own national public consultation, NHS England has already decided what changes to prescribing all Clinical Commissioning Groups (CCGs) need to implement.
These changes are detailed in guidance from NHS England on its website.
ELR CGG undertook engagement over six weeks between Monday 30 July and Sunday 9 September 2018. The CCG sought to obtain feedback to:
- Educate people about the rationale behind why items may not routinely be prescribed
- Make people aware of the NHSE consultation and its findings
- Identify any other risks and themes relating to conditions or groups of people which may require further engagement or work, before any changes are implemented
- Reassure those people with long-term conditions and/or complex conditions that they will continue to receive their prescription
Prepare patients for the changes so that they are aware and prepared for the changes before implementation
- Allow the CCG to determine whether people are generally in support of the proposals, so that appropriate communication and any further necessary actions can be put in place
- Achieve behaviour change in patients by encouraging them to self-care
Engagement methods employed included:
- An online survey promoted on the CCG’s website, GP practice websites and through local media. Paper copies were available in GP practices and on request. The survey was completed by 358 people
- Six face-to face engagement events hosted at some of ELR CCG’s largest GP practices using the CCG’s Listening Booth
- The opportunity for the public to share their views was promoted though communication channels including stakeholder briefings, website, media and social media
- Emails were sent to stakeholders and seldom heard groups, briefing them on the initiative, the rationale and requirements for all CCGs to implement the changes. The email also provided contact details, should any individuals or seldom heard groups want to request more information or a meeting
- All ELR practices were emailed an electronic toolkit including a patient-friendly one-page leaflet , copies of the survey, a poster, web articles and social media content. Paper copies were also delivered to practices
The survey was completed by 358 people and found that 92% of respondents were happy to purchase medicines and treatments available over the counter, to treat minor or self-limiting conditions. The national average is 65%, therefore support in ELR is much higher than the national average.
There were some areas for consideration identified by the survey including:
- concern from some groups (people with low incomes, older people and people who are housebound and those with long-term or more serious conditions) that they will be adversely affected by the changes
- level of awareness regarding changes, which medications will no longer be prescribed and that proposed changes will apply to short-term and self-limiting conditions only
- level of awareness of what a self-limiting condition is
In considering these issues, recommendations have been made to help address concerns and raise awareness of the changes. These are summarised below:
- Further publicity and promotion to reach as many patients as possible and on a long-term basis
- Emphasis placed in all promotion on what short-term conditions are in order to reduce unnecessary concerns of impact on those with complex and/or longer-term and more serious conditions who will be exempt from the changes. GPs will have a pivotal role in explaining this during patient consultations
- Patient’s circumstances also need to be taken into account by GPs to reduce any potential inequalities in health provision
- To assist in implementing the changes, the CCG should provide support to GPs to implement the changes (including provision on materials to help answer patient queries/concerns)
The full findings and detail of the recommendations can be found in the engagement report which is available here.
The findings from the CCG’s engagement work were highlighted in publicity to announce the implementation of the change on 1 October 2018. This took place via the media, social media and communication with stakeholders including Patient Participation Groups, with patients sign posted to the engagement report and supporting materials.
The findings and recommendations arising from public feedback have been taken into consideration in the implementation of the changes. Ongoing promotion of the changes is reflecting the key learning points and the CCG is providing support to GPs to assist patients to understand the changes. A review will take place six months after implementation to revisit the initiative to ascertain from GPs what the response has been from their patients.
This may help identify any further areas of work or engagement.