Gluten-free foods restricted on NHS prescriptions
Gluten-free foods restricted on NHS prescriptions
December 3, 2018
Community pharmacy teams are reminded that from Tuesday 4th December the gluten-free (GF) foods permitted on the NHS in England is restricted to bread and mixes only.
Revisions have been made to Part XV (the ‘ACBS list’) and Part XVIIIA (the ‘Blacklist’) of the December 2018 Drug Tariff to reflect this change in GF prescribing.
If a patient presents a prescription for any restricted GF foods in December, they will need to be referred back to the prescriber to discuss suitable alternatives.
PSNC has created the following briefing to explain the changes to the availability of GF foods on NHS prescription and what this means for community pharmacy teams.
PSNC Briefing 061/18: Changes to the availability of gluten-free foods on NHS prescription (updated 3rd December 2018)
Q. Which GF products will be allowed on an FP10 after the 4th December?
Below is a list of ACBS approved GF breads and mixes allowed on prescription from 4th December 2018. However, the prescribing regulations do not exclude GF breads and mixes not specified on the ACBS list and these will continue to be reimbursed if dispensed.
|Barkat gluten-free all purpose flour mix||Barkat gluten-free brown rice bread|
|Barkat gluten-free hi-fibre bread mix||Barkat gluten-free par-baked baguettes|
|Barkat gluten-free par-baked rolls||Barkat gluten-free par-baked white bread sliced|
|Barkat gluten-free wheat free multigrain rice bread||Barkat gluten-free white rice bread|
|Barkat gluten-free wholemeal sliced bread||Ener-G gluten-free brown rice bread|
|Ener-G gluten-free dinner rolls||Ener-G gluten-free rice loaf|
|Ener-G gluten-free Seattle brown loaf||Ener-G gluten-free tapioca bread|
|Ener-G gluten-free white rice bread||Finax gluten-free coarse flour mix|
|Finax gluten-free fibre bread mix||Finax gluten-free flour mix|
|Genius gluten-free brown sandwich bread sliced||Genius gluten-free seeded brown farmhouse loaf sliced|
|Genius gluten-free white sandwich bread sliced||Glutafin gluten-free 4 white rolls|
|Glutafin gluten-free baguettes||Glutafin gluten-free bread mix 32|
|Glutafin gluten-free fibre bread mix||Glutafin gluten-free fibre loaf sliced|
|Glutafin gluten-free high fibre loaf sliced||Glutafin gluten-free multipurpose white mix|
|Glutafin gluten-free part-baked 2 long white rolls||Glutafin gluten-free part-baked 4 fibre rolls|
|Glutafin gluten-free part-baked 4 white rolls||Glutafin gluten-free Select bread mix|
|Glutafin gluten-free Select fibre bread mix||Glutafin gluten-free Select fibre loaf sliced|
|Glutafin gluten-free Select fresh brown loaf sliced||Glutafin gluten-free Select fresh seeded loaf sliced|
|Glutafin gluten-free Select fresh white loaf sliced||Glutafin gluten-free Select multipurpose fibre mix|
|Glutafin gluten-free Select multipurpose white mix||Glutafin gluten-free Select seeded loaf sliced|
|Glutafin gluten-free Select white loaf sliced||Glutafin gluten-free wheat-free fibre mix|
|Glutafin gluten-free white loaf sliced||Glutenex gluten-free white bread mix|
|Innovative Solutions gluten-free bakery blend||Just: gluten-free good white bread sliced|
|Just: gluten-free good white rolls||Just: gluten-free white sandwich bread|
|Juvela gluten-free bread rolls||Juvela gluten-free fibre bread rolls|
|Juvela gluten-free fibre loaf sliced||Juvela gluten-free fibre loaf unsliced|
|Juvela gluten-free fibre mix||Juvela gluten-free fresh fibre loaf sliced|
|Juvela gluten-free fresh fibre rolls||Juvela gluten-free fresh white loaf sliced|
|Juvela gluten-free fresh white rolls||Juvela gluten-free harvest mix|
|Juvela gluten-free loaf sliced||Juvela gluten-free loaf unsliced|
|Juvela gluten-free mix||Juvela gluten-free part-baked fibre bread rolls|
|Juvela gluten-free part-baked fibre loaf||Juvela gluten-free part-baked loaf|
|Juvela gluten-free part-baked white bread rolls||Lifestyle gluten-free brown bread|
|Lifestyle gluten-free brown bread rolls||Lifestyle gluten-free high fibre bread rolls|
|Lifestyle gluten-free white bread rolls||Mums Mill gluten-free quick bread mix|
|Orgran gluten-free bread mix||Proceli basic mix|
|Proceli gluten free part-baked baguettes||Tobia Brown Teff Bread Mix|
|Tobia White Teff Bread Mix||Tritamyl gluten-free brown bread mix|
|Tritamyl gluten-free flour mix||Tritamyl gluten-free white bread mix|
|Warburtons gluten free brown bread sliced||Warburtons gluten free brown rolls|
|Warburtons gluten free white bread sliced||Warburtons gluten free white rolls|
Q. Will I be reimbursed for dispensing FP10 prescriptions for any GF food (except those previously Blacklisted) issued by the prescriber before the 4th of December 2018 but dispensed after this date?
The amendment to the Prescribing Regulations did not come in place until the 4th December 2018 so any NHS prescriptions for GF foods issued before this date remain valid for six months from the appropriate date. Therefore, FP10 prescriptions for all GF foods (except those previously Blacklisted) issued before the 4th December will continue to be reimbursed by the NHS BSA for up to six months after the appropriate date until the end of June 2019.
Q. One of our patients purchased a pre-payment certificate (PPC) to cover the cost of GF prescriptions; now they will only be able to access a limited range of products. Are they able to obtain a refund for their PPC?
No. A PPC cannot be refunded because of the amendments to the prescribing regulations of GF foods. Changes to GF prescribing were announced in February 2018 giving patients and NHS services an extended period of notice before the amended regulations came into force in December 2018. Pre-payment certificates cover all prescription medicines and not just GF food so can continue to be used until they expire. Patients can only claim a refund of a PPC if they become entitled to free NHS prescriptions.
Q. Will I be reimbursed for any batch issues of repeatable prescriptions for all GF foods (except those previously Blacklisted) that were issued by a prescriber before 4th December 2018?
Yes, repeatable prescriptions for all GF foods (except those previously Blacklisted) issued before the 4th December will continue to be reimbursed for up to 12 months after the appropriate date on the prescription until the end of December 2019. The amendment to the Prescribing Regulations which came into force on the 4th December 2018 restricts NHS prescribing of GF foods (except for GF breads and mixes) and any repeatable prescriptions for these issued on or after the 4th December will not be legally valid.
Q. Can I dispense a GF bread or food mix that is not listed on the ACBS list?
Food marketed as gluten-free or very low gluten may not be ordered under the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) (Amendment) Regulations 2018, unless they are gluten-free breads or gluten-free food mixes. Part XV (ACBS list) of the Drug Tariff lists GF breads and mixes that have been recommended by the Department of Health and Social Care (DHSC). However, pharmacies will continue to be reimbursed if a prescription is received for a GF bread or mix that is not listed in Part XV. Products held on dm+d that do not fall into the category of either being a GF mix or bread will have the Schedule 1 indicator applied. Products that are not listed on dm+d and are prescribed as mix or a formulation of bread will be reimbursed on prescription by the NHSBSA.
More information is available on the NHS Business Services Authority website.