Prescribing Policy:Gluten free foods
The prescribing of “staple” gluten free foods such as bread and pasta is supported by NHS Trafford.The prescribing of gluten free cakes, biscuits and pizza bases is not supported by NHS Trafford.
Background
Coeliac disease is unique among gastrointestinal disorders in that an effectivedietary treatment is available that will restore almost all patients to full health,and help to protect against the development of complications.
The best way to ensure good health is for patients to adhere to a strict gluten-free dietfor life (1).
Guidance
Trafford Commissioning Consortium (TCC) Medicines Management Group, Trafford Clinical Executive Committee (CEC) with Medicines Management (MM) Team support have reviewed the guidance for the efficacy and cost-effectiveness of staple gluten free foodsand feel it is strong enough to support continued appropriate prescribingof gluten free bread and pasta through NHS resources.
In the interests of promoting healthy eating in line with local and government initiatives the prescribing of gluten free cakes, biscuits and pizza bases will not be supported through NHS resources.
Prescribing of gluten free foods through the FP10 route has National ACBS approval through the Drug Tariff, which is compiled on behalf of the Department of Health by the NHS Business Services Authority & NHS Prescription Services. This means that in certain conditions some foods have characteristics of drugs and the ACBS advises as to the circumstances in which such substances may be regarded as drugs. Gluten free foods are approved under these circumstances for people with established gluten enteropathy with co-existing established wheat sensitivity(2).
It has been clearly shown that good dietary compliance is aided by the ease with whichpatients can obtain suitable amounts of gluten-free products on prescription. Coeliacdisease is a disorder readily treated by diet and every effort should be made to ensurethat patients understand this and have easy access to gluten-free products suitable fortheir needs and so reap the benefits of good health and well-being.
It is also apparent that those patients who are regularly reviewed adhere much betterto their gluten-free diet than those who are left to their own devices(1).
Prescribing Recommendations
- Appropriate quantities of bread and pasta can be prescribed for each coeliac patient within NHS Trafford as per practice prescribing policy
- Gluten free cakes, biscuits and pizza bases should not be prescribed within NHS Trafford
- Patients currently being prescribed cakes, biscuits or pizza bases should be identified and advised of this decision
Patient information
In line with government and local initiatives on healthy eating cakes, biscuits and pizza bases will not be prescribed within NHS Trafford. Patients can purchase these products through local supermarkets or local community pharmacies if they wish to do so.
Implementation of this policy
Coeliac society guidance on prescribing is available on request. The Medicines Management Team will be available to assist practices with implementation.
1. Coeliac UK, February 2004. 2. Drug Tariff, November 2010
Medicines Management Team 0161 873 9507/9585November 2010