Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they will request NHS England to permit the prescription of Thiamine capsules as an alternative to tablets.

Clinicians are responsible for making prescribing decisions for their patients, considering best prescribing practice and appropriate national and local guidance.

In respect of the prescribing of unlicensed medicines, the National Health Service’s long-established practice is reflected in professional guidance. Individual patient needs should be fulfilled by, firstly, using a licensed medicine within its licensed indication, or if there is nothing suitable, using a licensed medicine outside its licensed indication. If there is still nothing suitable after this, the clinician can consider using an unlicensed medicine.

Thiamine tablets are available as a licensed medicine. Thiamine capsules are not a licensed medicine. Thiamine supplements can be purchased from pharmacies or shops. These include vitamin B complex tablets and multivitamin tablets where thiamine is listed as an ingredient. NHS guidance states that vitamins and minerals should not be routinely prescribed in primary care as there is insufficient high-quality evidence to demonstrate their clinical effectiveness. However, subject to funding, a clinician can prescribe any product on the NHS that they consider to be clinically necessary for the treatment of their patient unless it is listed in Schedules 1 or 2 of the NHS (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004. Parts XVIIIA and XVIIIB of the NHS Drug Tariff list the drugs, medicines and other substance that may not be ordered, or may only be ordered on the NHS in certain circumstances under the above regulations.