NHS Liverpool Clinical Commissioning Group (CCG) argue that conditions such as coughs, colds and sore throats can get better themselves or be addressed by medicines available at pharmacies.
The thinking also extends to conditions that use treatments not proven to be clinically effective, such as for mild urine infections and mouth ulcers.
“As a CCG, we want to make sure that we are using NHS resources in Liverpool in the best possible way, and part of this means encouraging people to choose self-care for minor conditions where they are able to do so,” says Dr Fiona Lemmens, a Liverpool GP and chair of NHS Liverpool CCG.
“However, it’s really important to stress that no decisions have been made yet. We really want local people to tell us what they think about our proposed changes first.
“If there are any other circumstances than the ones we’ve already outlined, where limiting prescriptions for these items might affect or disadvantage people, we want to hear about it - and we’ll be going out into different communities over the coming weeks to help make sure we gather views from people right across the city.”
Money saved
Based on other areas where the guidelines have been introduced, NHS Liverpool CCG estimates that it could save €145,000 - €290,000 annually by limiting prescriptions for these items.
According to local media, Liverpool CCG spent €5,866 and €844,193 on probiotic and vitamin/mineral prescriptions respectively in 2018.
Commenting on the decision to possibly axe probiotics, the CCG says that while there’s some evidence that probiotics may be helpful in some cases, there is also “little evidence to support many health claims made about them.”
The CCG adds that unless there is a diagnosed vitamins and mineral deficiency there isn’t evidence to say they are effective.
The Group assure pregnant women, babies and young children that they are not affected by these proposals.
However, the move has been met with anger as city councillors criticised the proposals, and passed an emergency motion opposing the CCG's plans.
Councillor Angela Coleman said, "It will directly affect the health choices of the very poorest in our society if they have to pay for medications that were previously available free on prescription, and as a socialist I believe good health care is a basic requirement, regardless of ability to pay."
Omega-3 restrictions
The NHS have previously taken part in a similar exercise back in 2017, in which Omega-3 fatty acids, lutein and antioxidant supplements were scrapped under plans to abandon 'ineffective' and 'low value' treatments.
At the time, NHS England instructed prescribers not to, “initiate omega-3 fatty acids for any new patient,” and “deprescribe omega-3 fatty acids in all patients,”
The guidelines were based on the National Institute for Health and Care Excellence (NICE) recommendations formed from “a lack of robust evidence of clinical effectiveness or where there are significant safety concerns.”