Background

NHS England (NHSE) wanted public and patient views and opinions on proposals to limit the prescribing of 18 products considered relatively ineffective, unnecessary, inappropriate or unsafe for routine prescription in NHS primary care.

Action

MLCSU’s communications and engagement team and medicines management and optimisation (MMO) team worked together to conduct NHSE’s low value medicines consultation in autumn 2017 and lead the analysis and reporting of consultation findings.

NHSE received 5544 responses through the online consultation survey, and a further 195 written submissions by post or email. In addition, we held eight webinars for stakeholders, two face-to-face public and patient stakeholder events in London and Leeds, and three individual meetings with key stakeholder groups including industry, pain management and mental health.

We handled all the responses, via the different channels. All open responses were read and coded against themes. Answers to closed questions were plotted in graphs and charts. Specialist letters were summarised. We compiled a comprehensive consultation report. 

The responses to the consultation were presented to the NHS England board in a paper by Sir Bruce Keogh. As a result, the prescribing of some inappropriate or ineffective treatments was stopped, benefitting patients and reducing costs.

The responses led to NHS England altering some of their proposals. For example, for Liothyronine the joint clinical working group recommended its prescribing for any new

patient should be initiated by a consultant endocrinologist in the NHS, and that de-prescribing in ‘all’ patients would not be appropriate, as there were recognised exceptions. The recommendation was, therefore, changed to advise prescribers to de-prescribe in all appropriate patients.

I would like to thank the Midlands and Lancashire Commissioning Support Unit who provided a high quality service to NHS England; their analysis helped us understand a wide range of views on our proposed prescribing guidance for ‘Items that should not routinely be prescribed in primary care: guidance for CCGs’. The insight provided by the teams at the CSU was first rate and ensured that the NHS England Board understood what the public, patients, clinicians and key stakeholders thought of our proposals.”

Sir Bruce Keogh

(former) Medical Director
NHS England