Engagement – Gluten-Free Prescribing
Gluten free (GF) foods are prescribed to people who are diagnosed with gluten sensitive enteropathies or, as it is more commonly called, coeliac disease. When someone has coeliac disease their small intestine becomes inflamed if they eat food containing gluten.
Staple gluten free foods are available on prescription to patients diagnosed with gluten sensitivity enteropathies, and has been since the late 1960s when the availability of GF foods was limited. Gluten free foods are now readily available in supermarkets and a wider range of naturally gluten free food types are available, meaning that the ability of patients to obtain these foods without a prescription has greatly increased. Many Clinical Commissioning Groups (CCGs), like Telford and Wrekin, restricted the type and quantity of GF foods available on prescription prior to national engagement and a growing number of CCGs have discontinued GF prescribing altogether.
NHS Telford and Wrekin CCG decided to engage with patients and the wider public on a proposal to discontinue providing gluten free foods on prescription because the decisions that the CCG must make about how to spend its budget has implications for all residents of Telford and Wrekin. Locally this will release monies that can be invested in other local healthcare services. An Equality Impact Assessment was carried out prior to the engagement work
Patients, carers and the wider public were given the opportunity to have their say by taking part in a survey. In addition the engagement team visited the Bickerstaff Endoscopy Unit on a couple of occasions to speak to patients as they attended the Gastroenterology Clinic. During the engagement, information was sent to all GP practices.
The feedback from the engagement was analysed and presented to the Programme Management Committee (PMC) and the Performance, Planning and Quality (PPQ) Committee. The Telford & Wrekin CCG Governance Board in July 2018 were asked to consider the engagement report and support PPQ’s recommendation to disinvest in all gluten free prescribing for people with gluten sensitive enteropathies. The Board confirmed that they had considered the engagement report and the CCGS response to the key themes that were highlighted during the engagement process and endorsed the decision by the PMC and the PPQ to disinvest in all gluten free prescribing.
Information from the Coeliac Society around “Shopping on a Budget” has been distributed to GP practices and taken to the Telford Foodbank to add to any food parcels that are gluten free, to help support patients.