Treatments such as homeopathy, omega-3 oils, herbal remedies and vitamins will no longer be issued through NHS prescriptions.

In a bid to save the health service £141m GPs will no longer be able to write scripts for 'low priority' items.

This week NHS England announced that 18 items would be stringently restricted or blacklisted altogether.

The health service has opened a consultation with could led to tighter controls on thousands of over-the-counter drugs.

On the NHS prescription blacklist are: homeopathic treatments, herbal remedies, Omega-3 fish oils, co-proxamol, glucosamine and chondroitin; vitamins A, C, E and zinc; and rubefacients.

Kirklees has one of the highest rates for antibiotics being prescribed by GPs

And those products that will be more strictly controlled are: travel vaccines, trimipramine, dosulepin, prolonger-release doxazosin, immediate-release fentanyl, lidocaine plasters, liothyronine, oxycodone and naloxone combination; paracetamol and tramadol combination; perindopril arginine: once daily tadalafil.

Here are more details about the drugs and why they've been blacklisted or further restricted.


A doctor writing a prescription, as news breaks of travel vaccinations, gluten-free foods and omega-3 supplements may no longer be available on the NHS under major cost-cutting plans. Picture: Anthony Devlin/PA Wire

Homeopathy: Because there is "no clear or robust evidence" it works, NHS bosses say. Prescriptions for the alternative therapy were was costing the health service in England £92,000 a year.

Herbal treatments: Again, there is "no clear or robust evidence" to support their use. These cost the NHS £100,000 a year.

Omega-3 fish oils: NHS chiefs rules these can be obtained through diet and are of "low clinical effectiveness". They currently cost £6.3m a year.

Co-proxamol: A painkiller which has had its marketing authorisation withdrawn due to safety concerns. It had cost the NHS £9m a year.

Glucosamine and Chondroitin: Supplements prescribed for pain associated with osteoarthritis , but the NHS ruled they are of "low clinical effectiveness". Annual cost of £444,000.

Vitamin A, C, E and zinc: When used for age-related macular degeneration, something that had been costing £1.5m a year.

Rubefacients: Warming muscle rub products that are said to relieve pain for various conditions, but the NHS says there is limited evidence they work. Currently cost £4.3m. Topical non-steroidal anti-inflammatory drug (NSAID) items such as Ibuprofen and Diclofenac are still available.


Travel vaccines: Hepatitis B, Japanese Encephalitis, Meningitis A, Yellow Fever, Tick-borne encephalitis, Rabies and TB vaccines shouldn't be given if they are "exclusively for travel". The ban will not apply to other "appropriate" uses. Current spend: £4.5m.

Trimipramine: An antidepressent that is "significantly more expensive" than others. Current spend £19.8m.

Dosulepin: Formerly known as dothiepin, an antidepressant that carries warnings of toxicity and cardiac arrest. Current spend £2.6m.

Prolonged-release Doxazosin: A hypertension drug that NHS chiefs say cost six times an alternative immediate-release version. Current spend £7.8m.

Immediate-release Fentanyl: A strong opioid painkiller where the NHS says cheaper alternatives are available. This ban will not apply to people undergoing palliative care. Current spend £10.9m.

Lidocaine plasters: Used for pain relief for people recovering from shingles but of "low clinical effectiveness". This ban will not apply to certain patients, though. Current spend £19.3m.

Liothyronine: A drug used for patients with an underactive thyroid. This ban will not apply to some with thyroid cancer or those for whom a cheaper alternative doesn't work. Current spend £34.8m.

Oxycodone and Naloxone combination: Used to treat severe pain and can also be used second line in restless legs syndrome. But NHS says it is "unclear" what benefit the more expensive combination product adds. Current spend: £5m.

Paracetamol and Tramadol combination: Two pain relief medicines. NHS says there are no clear benefits of a combined product rather than taking each separately which is cheaper. Current spend £2m.

Perindopril Arginine: An 'ACE inhibitor' used for heart failure, hypertension and other conditions. An alternative version is cheaper. Current spend £529,000.

Once Daily Tadalafil: An erectile dysfunction drug. NHS chiefs say it should be prescribed "when required" instead. Current spend £11.5m.

These thousands of everyday products COULD be banned too

Stock image

NHS chiefs want to go further.

They're consulting on plans to stop thousands of cheaper, over-the-counter products being prescribed on the NHS if they are used for short-term or low-level conditions.

Those plans would include paracetamol, cough mixture, cold treatments, eyedrops, laxatives and sun cream.

The cuts are being decided by the condition medicines treat, not the medicines themselves.

But they could include medicines for cold sores, conjunctivitis, coughs and colds, cradle cap, haemorrhoids, infant colic, dandruff, diarrhoea, ear wax, mild indigestion, malaria prevention, minor burns and scalds and minor pain conditions such as headache and back pain.

Treatments for mouth ulcers, nappy rash, ringworm, head lice, mild toothache, travel sickness, and warts and verrucae could also be restricted.

Vitamins and minerals may also be restricted.

NHS England chief executive Simon Stevens said: “We're determined to make taxpayers' money go further.

"The NHS should not be paying for low value treatments and it's right that we look at reducing prescriptions for medicines that patients can buy for a fraction of the price the NHS pays."

His officials said, incredibly, it can cost £34 for a pack of 32 paracetamol tablets prescribed on the NHS - once dispensing and GP consultation fees are included.

Who will suffer?

Patients Association chief executive Rachel Power said the prescriptions crackdown "will be difficult and have complex consequences" for the doctor-patient relationship.

Don Redding, director of policy at National Voices, a coalition of 160 health and care charities, warned of the consequences for poor, young or old people who get free prescriptions.

He said: "If taken forward, these plans could mean that some treatments are only available to those who can afford them.

"Yes, there are difficult decisions for the NHS to make, but the rationing of treatments should not be targeted at those most in need, and those already living on a financial knife-edge."

What will it save?

The confirmed recommendations today are set to save £141million a year, the NHS says.

The second plan for over-the-counter products could reportedly save another £190million a year.

And when will it all happen?

The first plan could be put into action any day now by the Department of Health - but there's no set timescale.

There's no set timescale on the second plan either, but this one will take longer - the next step of consultation is in 2018.

Finally... what about gluten-free foods?

Thomas Lynen of Honley who is concerned that gluten free bread is no longer available on prescription.

The original consultation in March had included gluten-free foods, but they've since been removed because the Department of Health is consulting separately.

That doesn't mean they won't be banned - there's just no decision yet.

Around one in 100 people have coeliac disease, caused by a reaction to gluten, that can be treated by cutting the substance from a patient's diet.

Once diagnosed as coeliac by a doctor, patients in most parts of the UK can receive gluten-free staple foods from a pharmacy through a prescription from a GP.

Foods approved for prescription include bread or rolls, breakfast cereals, crackers and crispbreads, flour and flour-type mixes, oats, pasta and pizza bases.