Background Coeliac disease is an auto immune disease where the body’s immune system attacks its own tissues. In people with coeliac disease this immune reaction is triggered by gluten, a collective name for a type of protein found in cereals, wheat, rye and barley. A few people are also sensitive to oats. (Coeliac UK www.coeliac.org.uk )
Coeliac disease requires lifelong exclusion of gluten from the diet and dietary compliance is the key to successful management. Many everyday foods are gluten free e.g. potatoes, rice, fruit, vegetables, meat, fish, corn and rice based cereals etc.
People with coeliac disease are prescribed certain gluten-free products to replace everyday foods that normally contain gluten. Prescribing of these products is used together with a full dietary assessment and advice from a registered community dietitian.
It should be noted that some patients who pay for prescriptions may find it cheaper to purchase items themselves from the supermarket rather than pay prescription charges.
The need to make the best use of resources and the increased availability of gluten-free products led to a review of the Policy on Prescribing Gluten-Free Food. The policy operates across most of the South East Coast region and has been agreed by heads of medicines management from several PCTs in the area.
The decision has been taken across most of Surrey, Sussex and Kent to limit prescribing of gluten free foods to 8 items of long life bread or flour each month.
NHS East Sussex Downs and Weald and NHS Hastings and Rother Statement:
The NHS has to make difficult choices about the products it supplies on prescription to ensure a cost effective and fair use of NHS resources for all its patients.
There were two main reasons why the decision to limit prescribing of gluten free foods has been made; the cost effective use of NHS resources and the equity of the supply of dietary products to all patients who have problems with certain types of foods.
We will still be funding bread as we appreciate that it is considered to be a staple food in the UK. Flour is also still available on prescription which allows people to make fresh bread, cakes and biscuits should they choose to do so.
However, as a wide range of gluten free products are now available in the supermarkets, which was not previously the case, it is felt reasonable and fair to expect people to buy some of their own foods, as we do not pay for food for patients with other long-term food intolerances (e.g. people with nut allergies). Additionally, the vast majority of foods are naturally gluten free.
We do recognise that specialist gluten free products cost more than gluten containing items and therefore have looked at ways in which we can minimise the financial pressure. By providing some gluten-free products on prescription the increased cost of maintaining a gluten free diet is supported to an extent that the average weekly food bill would be similar to that of the rest of our population.
It may be interesting to note that the prices the NHS pays for gluten free foods on prescription are approximately double the price of gluten free items available to purchase from supermarkets. Manufacturers and wholesalers can charge the NHS significantly more for gluten free products due to inflated delivery, handling and administration costs.
Frequently Asked Questions
Please download our frequently asked questions sheet for more information, including where to find appropriate recipes.
