Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential impact of integrated care boards limiting access to prescriptions for gluten-free products on people with coeliac disease.

The Department does not plan to make such an assessment. NHS England guidance on prescribing gluten-free foods in primary care was developed in 2018 to communicate to clinical commissioning groups (CCGs). The guidance stated that CCGs may further restrict the prescribing of gluten-free foods by selecting bread only, mixes only or they may choose to end prescribing of such foods altogether having considered whether it is appropriate for their population, taking account of their legal duties to advance equality and have regard to reducing health inequalities. The guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/11/prescribing-gluten-free-foods-primary-care-guidance-for-ccgs.pdf

Decisions about the commissioning and funding of local health services are now the responsibility of local integrated care boards (ICBs), rather than CCGs. NHS England guidance should be considered when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practice. The guidance does not remove the clinical discretion of prescribers in accordance with their professional duties.

The national prescribing position in England remains that gluten free bread and mixes can be provided to coeliac patients on National Health Service prescription and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.