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Important Changes in NHS Prescribing

NHS Clinical Commissioning

In March 2018, NHS England introduced changes to the way some ‘over the counter’ medicines are prescribed. Under the new guidance, Greenwich GPs will no longer routinely write prescriptions for parents/carers of children and young people to treat coughs and colds, dry skin, upset tummies, minor cuts, and other short-term minor ailments and injuries.

Instead, parents/carers are being encouraged to treat their children’s short-term minor health problems at home, with over the counter (OTC) medicines where appropriate, and with support from their local pharmacy if needed. A list of the short-term minor health conditions for which GPs will not routinely prescribe over the counter items can be found below.

Greenwich GPs will continue to treat patients according to their individual circumstances and needs, and use their clinical judgement when considering whether it is appropriate to ask a patient’s parent or carer to purchase over-the-counter medication.

The change may have implications for your educational setting as children may be given over the counter medication without the need for a prescription. Guidance from the Department for Education advises:

  • Schools and early years providers must have and implement a policy and procedures for giving medicines, including setting out the circumstances in which non-prescription (over the counter) medicines may be administered.
  • Non-prescription medication, e.g. for pain relief, should never be administered without first checking maximum dosages and when the previous dose was taken. Aspirin should never be given to a child under 16 years unless it has been prescribed by a doctor.
  • Prescription medicines must not be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist (medicines containing aspirin should only be given if prescribed by a doctor).
  • Medicines (both prescription and non-prescription/OTC) must only be administered to a child where written permission for that particular medicine has been obtained from the child’s parent and/or carer.
  • Providers must keep a written record each time a medicine is administered to a child, and inform the child’s parents and/or carers on the same day, or as soon as reasonably practicable.

Additional guidance may be found here:


Guidance on conditions for which over the counter items should not routinely be prescribed in primary care – March 2018:
https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/ 

Supporting Pupils at School with Medical Conditions – December 2015:
https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3

Statutory framework for the early years foundation stage 3 April 2017:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/596629/EYFS_STATUTORY_FRAMEWORK_2017.pdf


Following the new NHS England guidelines, Greenwich GPs will no longer routinely prescribe medications to treat the following minor health conditions:
 Mild Irritant Dermatitis
 Dandruff
 Dry Eyes/Sore tired Eyes
 Earwax
 Head Lice
 Indigestion and Heartburn
 Infrequent Constipation
 Infrequent Migraine
 Insect bites and stings
 Mild Acne
 Mild Dry Skin
 Sunburn due to excessive sun exposure
 Sun Protection
 Mild to Moderate Hayfever/Seasonal Rhinitis
 Minor burns and scalds
 Minor conditions associated with pain, discomfort and/fever. (e.g. aches and sprains, headache, period pain, back pain)
 Mouth ulcers
 Nappy Rash
 Oral Thrush
 Prevention of dental caries
 Ringworm/Athletes foot
 Teething/Mild toothache
 Threadworms
 Travel Sickness
 Warts and Verrucae


Exceptions to this include:

  • Where an over the counter medicine is outside of its marketing authorisation, also known as “off-label use” or “unlicensed use”.
  • Where an over the counter medicine is being prescribed for a long-term (chronic) condition
  • Where there are possible safeguarding concerns including, but not limited to, children, where there might be concerns that treatment might otherwise not be provided.

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