Please don't ask your doctor for 'over the counter' medicines

People in Norfolk and Waveney are being urged not to ask their doctor for everyday medicines like paracetamol as part of a new campaign.

Norfolk and Waveney’s NHS Clinical Commissioning Groups are asking GPs not to routinely prescribe ‘over the counter medicines’ for some common conditions, unless in exceptional clinical circumstances.

Instead, people are being encouraged to buy them at a pharmacy or shop so that the NHS can spend the money it would otherwise cost on other areas of healthcare. If more people self-care for minor ailments, it could also free up important appointment time at GP practices.

The CCGs have joined forces to launch the new campaign after figures showed the local NHS spent £5.7m last year on remedies for minor conditions such as diarrhoea and indigestion, as well as medicines such as paracetamol.

Of this total, £800,000 was spent on muscle pain medication which costs just £1.60 for patients to buy themselves, while £666,000 went on allergy medication. A further £2m was spent on moisturising lotions – money which could have paid for 339 hip replacement operations.

The Norfolk CCGs carried out an online survey to gather public opinion about the subject, which attracted nearly 400 responses and showed the public were broadly supportive of the concept. Many other areas in England have also taken a similar approach.

Dr Dustyn Saint, GP at Long Stratton Medical Partnership and a member of NHS South Norfolk CCG’s governing body, said: “In the current challenging times, we need to recognise that the NHS only has a finite amount of money and a duty to spend this in a way that achieves the best possible outcomes for all of our patients. We think it is a better option for most people to buy a box of paracetamol for 20 or 30 pence from a supermarket rather than expecting their GP to prescribe the same thing at a significantly increased cost.

“This is not just about money, it is also about prioritising the use of GP appointments, enabling our family doctors to focus on caring for higher risk patients, such as those with complex needs, the very young and elderly, managing long-term conditions and providing new services.

“We do still fully appreciate that there will be instances where a patient’s clinical needs mean that these items will still need to be available on prescription, for example those with long-term medical conditions who require large quantities of certain items.”

Michael Dennis, a medicines management expert with the CCGs, said: “Your first port of call if you’re suffering with a minor illness should always be your pharmacist. They are highly-trained healthcare professionals who can offer help and advice about a huge range of common illnesses without booking an appointment, as well as recommending the right medication to help you self-care at home. By speaking to them first, you could also save yourself a visit to your GP and help free up appointments for other patients in greater need.

“Doing your bit is simple, so please help your NHS by caring for yourself wherever possible and buying your own medicines so that we can make the best use of our resources for the benefit of everyone in Norfolk and Waveney.”

GPs still have discretion to prescribe items depending on clinical circumstances, for example for people who require large quantities of particular medicines for long-term illnesses.

You can follow the campaign on Twitter @YourMED_YourNHS and use the hashtags #selfcare and #askyourpharmacist

Feedback received during the engagement exercise will be posted on the Norfolk and Waveney CCG websites and includes:

• “I think it an excellent idea. I think it may be met with resistance (much like the 5p bag charge at supermarkets) but overall it will not have much impact on people and will be very useful for reducing costs to the NHS. People do not like changes where they have to take more responsibility for the resources they use.”

• “I fully believe and have always believed that we should be buying our own cough mixtures, paracetamol etc etc.”

• “I would be much happier with this arrangement, because it also tells me that my ailment is not thought to be serious enough for specialist medication, and it means there is less strain on the NHS.”

As anticipated, concerns were also raised:

• “Paracetamol only comes in small doses over the counter and I would have to keep leaving the house to purchase whereas I receive 100 from the doctor.” – GPs have clinical discretion.

• “I have a long-term condition which relies on some of these but tend to buy myself anyway rather than add to prescriptions. I would be concerned that people who receive free prescriptions would not be able to continue to receive them if a complete ban on these is put in place.” A ban has not been put in place, the CCGs are supporting GPs to not prescribe the items where they feel it is not necessary. GPs will still be able to prescribe at their discretion for long term conditions and where they feel it is clinically appropriate.

• “I don’t mind paying for a prescription at all but I do prefer the medicine the doctor prescribes than one of the alternatives from the chemist as it doesn’t work as well.” Pharmacists can advise on generic / non-branded medication which contains the same ingredients and works as effectively.

Your GP appointment - keep it or cancel it

GPs across central Norfolk are reminding patients who have booked an appointment to keep it or cancel it.

Everyone knows that GPs and practice nurses are really busy. They try to offer as many appointments as possible on the day, or to suit each patient.
But if people fail to show, it means someone else could have had that appointment.

Added up, the number of minutes attributed to ‘did not attends’ by GP practices in central Norfolk equates to something like 7 doctors a year.

Should the NHS routinely prescribe medicines for minor and short-term ailments?

The four NHS Clinical Commissioning Groups (CCGs) in Norfolk are asking for people’s views on whether they should stop routinely prescribing some everyday medicines which can be purchased from a pharmacist.

They have launched a four-week period of public engagement to gather feedback from local people and stakeholders.

Every year, the NHS in Norfolk spends more than £5 million on prescribing items for minor, short-lived ailments such as paracetamol, remedies for indigestion or heartburn, allergy treatments, vitamin supplements and cream for dry skin, items which are readily available over the counter from pharmacies and local shops.

Medicines to treat these short-term and minor ailments are inexpensive and are often available from shops or pharmacies. However, when provided on prescription, they cost the NHS significantly more. This is partly because of the cost of the medicines, but also includes GP time, dispensing time and fees, and processing.

Dr Dustyn Saint, GP at Long Stratton Medical Partnership and NHS South Norfolk CCG Governing Body Member said: “At a time when the NHS is facing huge financial pressures, we have to look at where we can best utilise every pound we spend on behalf of taxpayers. By asking patients to buy medications for minor ailments themselves we will be able to use the money for our core NHS services.

“The views of our patients and of the wider general public are very important to us and for this reason we are inviting people to share their views, comments and feedbacks with their local NHS Clinical Commissioning Groups via the surveys available.”

This engagement exercise coincides with ‘self-care’ week 2017. The NHS belongs to everybody and collectively we must ensure that its resources are used in the best possible way for all patients.

This is not just an issue of cost as a significant proportion of GP appointments, GP practice and community pharmacy time is taken up in processing prescriptions for minor ailments. Currently around 20 per cent of a GP’s time and 40 per cent of their total consultations are used for minor ailments and common conditions at a cost of on average £2 billion per year to the NHS.

Reducing the number of requests for every day medicines will free up GP time to focus on caring for higher risk patients, such as those with complex needs, the very young and elderly, managing long-term conditions and providing new services.

Where appropriate over the counter medicines will still be available at the GPs discretion if needed to treat a long-term condition for example.

Françoise Price, a pharmacist and medicines management lead for the CCGs, said: “There are times when over the counter medicines are required and advice can be sought from other trained health professionals including pharmacists. Pharmacists are a great source of knowledge in terms of medicines and treatments meaning you can get help and treatment quicker, easier and at a time that suits you.”

“To be clear, GPs will not stop prescribing any medications when they feel this is appropriate; our aim is to encourage patients to access healthcare advice and treatment from an appropriate healthcare professional (pharmacist) and to encourage patients to buy over the counter medicines that can be used to treat minor ailments rather than get them on prescription, and maintain a stock at home to take when they need it. Additionally, we’re not asking people to go without medication they need – those who need regular medication such as paracetamol and ibuprofen because of long term medical conditions will still be able to get them on an NHS prescription. GPs will still retain discretion for prescribing medication for high risk or vulnerable patients or where they suspect a patient might not be in a position to obtain the medication themselves.”

The public engagement will continue from Thursday 2nd November 2017 until Friday November 24th.  

Patients given a voice on NHS transformation plans

Patients across Norfolk and Waveney will get to have their say on plans to transform the region’s health and care system at a series of consultation events being held later next month.

The events have been organised by consumer champion, Healthwatch Norfolk, following public concerns over a lack of available information on future plans for local services under the Sustainability and Transformation Partnership (STP).

Our health and social care services face some big challenges and the partner organisations involved in the STP are tasked with developing a five-year programme of change to meet the challenges ahead.

These first events will focus on urology, cardiology and radiology services, with a separate session at each venue devoted to the future of GP services.

Meetings are being held in Great Yarmouth, King’s Lynn and Norwich, at varied times, to make them as accessible as possible for everyone wishing to attend.
All events are free to attend but tickets are limited so please book your place directly through the Healthwatch Norfolk website at or call Healthwatch on 01953 856029 to reserve your place.

Full details of each meeting are as follows:

22 November at Roundwood Conference Centre, Taverham
• The Future of GP Services 3.00pm – 5.30pm
• Urology, Cardiology and Radiology 6.00pm – 8.30pm

27 November at Town Hall, King’s Lynn
• Urology, Cardiology and Radiology 3.00pm -5.30pm
• The Future of GP Services 6.00pm – 8.30pm

1 December at Kings Centre, Great Yarmouth
• The Future of GP Services 10.00am – 12.30pm
• Urology, Cardiology and Radiology 1.30pm – 4.00pm

Each event will be chaired by former Norfolk Coroner and Healthwatch Norfolk Chair, William Armstrong, who will be joined by relevant clinicians and Antek Lejk, the executive lead for the STP.

Ambulance response times

The ambulance service is now working to meet new response times, being introduced across the country.

When you dial 999, the ambulance operators are now given more time to talk with you and decide the most appropriate response. The average times for a response have been changed and they differ depending on how serious the emergency is. The ambulance service will always try to get to those people who are in most need and the new standards will help them dedicate the right resource for the right outcome.

You can read more in this pdf infographic (589 KB) .

Remember - our ambulance service is really busy. Please only dial 999 if it is a genuine emergency. If it is urgent but not an emergency then call 111.


Expert report says there’s never been a better time to stop smoking – coincides with launch of Stoptober

  • Healthy Norwich logoHighest quitting success rate on record in first 6 months of 2017
  • First time ever increase driven entirely by successes among the less well off
  • Expert report says there’s never been a better time to quit with e-cigarettes one of the key drivers
  • Launch of Stoptober mass quit event sees new TV ad feature e-cigarettes for the first time

New data published today shows quitting success rates at their highest for at least a decade, up to 19.8% for the first six months of this year, significantly higher than the average for the last 10 years (15.7%).

  • Success rates among the less well off have for years remained stubbornly low, but in a major turnaround the sharp increase in success rates is being seen entirely among this group. For the first time, any smoker - no matter their background or job, sex, age, where they live has virtually the same chance of quitting successfully as the next person.

Norfolk Football clubs campaign for healthier playing areas with ‘Smokefree Sidelines’

Smokefree Sidelines logo#SmokefreeSidelines is a new initiative with the aspiration to prevent smoking tobacco in football environments being seen as normal. It aims to encourage spectators to refrain from smoking pitchside and near playing areas, where impressionable children and young people can see it. 

The campaign was launched in July at Norfolk FA’s largest tournament - The FDC Youth Cup, by NHS Norwich Clinical Commissioning Group (CCG), Smokefree Norfolk and Norfolk FA, with the support from Norfolk District Councils. In the last two months 12 clubs have signed up to become a ‘Champion’ of the scheme for their district. Fakenham Town FC were the first club to get involved in the project, flying the flag for North Norfolk, with Horsford Youth and Aylsham following up for the Broadland District.