Over-the-Counter and Branded Medicines Policy

Our approach to medicines

We want to ensure that medicines are prescribed safely, effectively and fairly, and that NHS resources are used responsibly. Our prescribing decisions are based on clinical need, evidence, safety and national and local prescribing guidance.

Over-the-counter (OTC) medicines

Many medicines used to treat minor, short-term or self-limiting conditions are available to buy from a pharmacy, supermarket or other retailer. NHS guidance advises that these medicines should not routinely be prescribed on an NHS prescription where they are suitable for self-care.

Examples include treatments for coughs and colds, hay fever, congestion, indigestion, minor pain, mouth ulcers and a range of other common minor conditions.

Where appropriate, we will advise you to purchase an OTC medicine and may recommend that you speak to your community pharmacist, who can provide advice about the most appropriate treatment.

There are some circumstances where an OTC medicine may still be prescribed. These can include certain long-term conditions, or more complex illnesses but this would be a clinical decision based on guidelines and not based on patient request.

Being exempt from prescription charges does not automatically mean that an OTC medicine will be prescribed. Your clinician will consider your individual circumstances and clinical needs.

We recognise that the ability to pay for an OTC medicine can be a genuine barrier to accessing healthcare. Where financial circumstances are a significant factor in a decision to prescribe an OTC medicine, we will consider this as part of a wider, holistic assessment of your circumstances. This may include offering or signposting you to appropriate support with benefits, debt, household finances or other sources of financial assistance, rather than viewing the prescription in isolation.

Previously prescribed Over-the-Counter medicines

In line with national NHS guidance and regional prescribing recommendations, the practice is regularly reviewing the medicines we prescribe to ensure that they are clinically appropriate, evidence-based and represent the best use of NHS resources. NHS England provides guidance and implementation resources to support practices in reviewing prescribing of medicines that are available to purchase over the counter.

As part of this ongoing work, some patients may be contacted or advised during a consultation that a medicine which has previously been prescribed on an NHS prescription is now more appropriately obtained over the counter from a pharmacy, supermarket or other retailer. A previous prescription does not necessarily mean that a medicine will continue to be routinely prescribed.

Where there are particular health, social or financial circumstances that may make self-care difficult, such as for patients in nursing or residential care, this will be taken into account. Where financial difficulty is a significant factor, we will consider this as part of a wider holistic assessment and, where appropriate, offer or signpost you to support with financial, benefits or other relevant needs.

These changes are part of our commitment to providing safe, effective and sustainable healthcare and ensuring that NHS prescribing resources are directed towards treatments where there is a clear clinical need.

Branded medicines and generic medicines

We normally prescribe medicines by their generic name where a suitable generic medicine is available.

A generic medicine contains the same active ingredient as the corresponding branded medicine and must meet the required standards for quality, safety and effectiveness. For most medicines, there is therefore no clinical reason to prescribe a particular manufacturer's brand.

We will only prescribe a branded medicine where there is a clear, evidenced clinical rationale for doing so.

Examples of circumstances where prescribing by brand may be clinically appropriate include particular medicines where the brand itself is important to ensure safe or consistent treatment, or where specific characteristics of the product—such as formulation, delivery device or other clinically relevant differences—mean that a particular product is necessary for an individual patient.

The decision to prescribe a particular brand is a clinical decision made by the prescriber. It will be based on the available evidence, relevant prescribing guidance, the characteristics of the medicine and your individual clinical circumstances.

Patient preference for a particular brand is not, on its own, a clinical reason for us to prescribe that brand. We are therefore unable to routinely accommodate requests for a particular branded medicine simply because you have used it previously, find it more familiar, or believe it works better when there is no clear clinical evidence to support the need for that particular brand.

If there is a genuine clinical reason why you require a particular branded medicine, please discuss this with your clinician. We will consider your circumstances carefully and make an appropriate clinical decision.

Where a medicine is clinically suitable to be prescribed generically, a pharmacy may supply an appropriate generic manufacturer's product. The appearance, packaging or manufacturer may therefore change without any change to the active medicine or the treatment you receive

Our commitment to you

We understand that decisions about medicines can sometimes be frustrating, particularly if you have previously received a particular product. Our prescribing policy is not intended to prevent you receiving medicines that you genuinely need.

Instead, we aim to ensure that:

• prescribing decisions are based on clinical need and evidence;
• medicines are prescribed safely and appropriately;
• NHS resources are used responsibly;
• financial or social difficulties are considered as part of your wider circumstances;
• appropriate support is offered where financial hardship is affecting your ability to access treatment; and
• individual clinical circumstances are considered rather than applying rules without regard to your needs.

If you are unsure about a medicine, or are concerned that you cannot afford a treatment recommended for you, please discuss this with your GP, practice pharmacist or community pharmacist. Please do not stop taking prescribed medication or change how you take it without seeking professional advice.