Further Infringements on our right to choice in the NHS

Prescibing of Homeopathic and other remedies and medicines on the NHS

As some of you may be aware the NHS has been having a look at whether we, the people, would like to use homeopathy on the NHS.

They have issued a consultation document or survey on a number of issues to gauge our response to this and other issues. The survey is a 48 page document involving other issues as well as the prescribing of Homeopathic Remedies, Anthroposophic Medicine and Herbal Remedies.

Please read through the following links all of which can be downloaded as PDF documents or editable Word documents.

Please respond to this attempt to again limit our right to choice in the NHS.  The deadline for this is 21st October 2017 so please act now.

Step by Step Instructions on how to respond.

There are 3 ways to respond:

  1. Write a letter and post it to NHS England or your local MP. The suggested content is given below for your convenience via downloadable links. Once downloaded they can be copied and pasted into your letter or modified directly.
  2. Send this letter by email – the same process as above just using email.
  3. Respond to the consultation document directly via the Engage England Website

The consultation document can be read here in its entirety. Or cut and paste this link into your browser.

https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed/supporting_documents/consultationitemsnotroutinelyprescribedinprimarycare.pdf

Letter to NHS England

PDF Format                MS Word Format

Please edit as you see fit. The contact details for NHS England are

Email: england.contactus@nhs.net
General Post (including complaints):  NHS England, PO Box 16738, Redditch, B97 9PT

LETTER TO YOUR MP

PDF Format             MS Word Format

Please edit as you see fit.

The contact details for your MP can be found here.

As we are in Stroud the MP is Dr David Drew and his address is

Dr David Drew, House of Commons, London, SW1A 0AA

Email: david.drew.mp@parliament.uk


DIRECT RESPONSE TO THE CONSULTATION DOCUMENT VIA Engage England Website

Letter A

Items which should not be routinely prescribed in primary care: A Consultation on guidance for CCGs “ 

Responding to the consultation paper which can be found on

https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed/supporting_documents/consultationitemsnotroutinelyprescribedinprimarycare.pdf

 It is 48 pages long, and covers a range of other issues as well, but if you don’t want to go through all the other issues of the survey, you can concentrate on expressing your views on withdrawing homeopathic and herbal medicines from the NHS.

To do this your response can be done electronically by accessing the consultation survey below.

https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed/consultation/intro/

The questions include the following which we offer possible responses you may wish to make.

In which capacity are you responding?

Patient

 Have you read the document “Items which should not be routinely prescribed in primary care: A Consultation on guidance for CCGs”?

 Yes

 Equity and Health Inequalities

Do you feel there are any groups, protected by the Equality Act 2016, likely to be disproportionately affected by this work?

Yes

 Equity and Health Inequalities – continued

Do you feel there are any groups, protected by the Equality Act 2016, likely to be disproportionately affected by this work?

Religion or belief

Please provide further information on why this might be the case.

Patients like me who believe in more holistic and natural approaches to my medical care.

 Equity and Health Inequalities – continued

Do you feel there is any further evidence we should consider in our proposals impact on health inequalities experience by certain groups e.g. people on low income; people from BME communities?

Yes

 Please provide further information on why this might be the case.

Low income patients who experience benefit from herbal, homeopathic and anthroposophic medicines are to be denied access to the treatment of their choice.

 Proposals for CCG Commissioning Guidance

Do you want to provide views on the proposals for CCG Commissioning Guidance?

Yes

 Homeopathy

 Advise CCGs that prescribers in primary care should not initiate homeopathic items for any new patient.

Disagree

 Advise CCGs to support prescribers in deprescribing homeopathic items in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.

Disagree

 If needed provide further information.

The grounds quoted are cost saving with the annual spend of around £100,000 for homeopathic medicines and a lack of evidence of effectiveness.

 The removal of these medicines from NHS prescribing will reduce the freedom of choice for patients and particularly those financially disadvantaged who can less easily afford to pay for them privately. This will increase inequality between less and more affluent patients.

 The imagined saving of £100, 000 for the whole country would represent a fraction of the drugs budget for a single NHS General Practice.

 The reality in practice is that by including homoeopathic (and herbal) medicines in General Practice prescribing it has been possible to demonstrate substantial overall savings for the NHS through appropriately reducing the prescribing of conventional drugs.   So, the quoted cost saving will in fact be illusory.

 The contrary to what is stated there is considerable evidence for the effectiveness of homeopathic medicines (see review by Dr Peter Fisher) However much evidence is gathered for the effectiveness of homeopathy it is always dismissed and regarded as no more than a placebo effect because it is difficult to understand with current scientific reductionist beliefs. But difficulty understanding homeopathy is no reason to ban it from NHS prescribing.

 It is recognised that the main threat to future public health is growing bacterial antibiotic resistance through over prescribing of antibiotics. Practices using homeopathic, herbal and anthroposophic medicines have demonstrated huge reductions in antibiotic prescribing with better clinical outcomes and improved patient satisfaction (evidence can be provided on request) Their use could offer a major contribution to overcoming the problem of antibiotic resistance if they were promoted by the NHS (with appropriate monitoring) rather than excluded from NHS primary care prescribing.

If you would like to provide views on any other medication, please select from the list below:

 Herbal Treatments

Advise CCGs that prescribers in primary care should not initiate herbal items for any new patient.

Disagree

 Advise CCGs to support prescribers in deprescribing herbal items in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.

 Disagree

If needed provide further information.

 The grounds quoted are cost saving with the annual spend of around £100,000 for herbal medicines and a lack of evidence of effectiveness.

 The removal of these medicines from NHS prescribing will reduce the freedom of choice for patients and particularly financially disadvantaged who can less easily afford to pay for them privately. This will increase inequality between less and more affluent patients.

 The imagined saving of £100, 000 for the whole country would represent a fraction of the drugs budget for a single NHS General Practice.

 The reality in practice is that by including herbal and homoeopathic medicines in General Practice prescribing it has been possible to demonstrate substantial overall savings for the NHS through appropriately reducing the prescribing of conventional drugs.   Such savings considerably outweigh the costs of prescribing these natural medicines. So, the quoted cost saving will in fact be illusory.

 The contrary to what is stated there is considerable evidence for the effectiveness of some herbal medicines such as St John’s Wort for depression and Hawthorn for Hypertension.

 It is recognised that the main threat to future public health is growing bacterial antibiotic resistance through over prescribing of antibiotics. Practices using herbal, homeopathic and anthroposophic medicines have demonstrated huge reductions in antibiotic prescribing (with better clinical outcomes and improved patient satisfaction – see attached references). Their use could offer a major contribution to overcoming the problem of antibiotic resistance if they were promoted by the NHS (with appropriate monitoring) rather than excluded from NHS primary care prescribing.

 Items that are prescribed in primary care and are available over the counter

Please provide your views and / or any relevant evidence we should consider when developing these proposals to potentially restrict items that are available over the counter.

Scientific Evidence and Homeopathy by Peter Fisher

 Anthroposophical versus Conventional Therapy of Acute Respiratory and Ear Infections: a Prospective Outcomes Study

H J Hamre et al. Wiener Klinische Wochenschrift 2005

Do you agree with our proposed criteria to assess items for potential restriction?

Neither agree nor disagree

 If needed please provide further information.

 It should also fully acknowledge and take account of the substantial evidence for the effectiveness of both herbal and homeopathic medicines.

  It should not be unduly influenced by the highly contested 2010 Science and Technology Select Committee Report or pressure groups such as the “good thinking society” which appear to seek to limit medical practice and thought to the current dominant scientific paradigm.

 To be aware of the loss of choice for patients which has been safeguarded since the inception of the health service by successive Ministers of Health assurances – that “the NHS will fund homeopathic treatment, as long as doctors wish to prescribe it and patients wish to receive it” – and all for relatively insignificant saving if indeed any real savings.


 

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