New analysis reveals GPs prescribing practices for quitting services and treatment

A report published by the British Lung Foundation highlights a 75% decline in stop smoking aids being prescribed by GPs and pharmacists across the country. The new analysis suggests that smokers are being discriminated against. Clinical Commissioning Groups are prioritising saving money over saving lives and flouting the basic principles of the NHS, to care for people, warns the British Lung Foundation.

‘Less Help to Quit: What’s happening to stop smoking prescriptions across Britain’ outlines the tactics being used by CCGs, to discourage GPs from providing their patients with clinically proven treatments to help them beat their addiction. It argues that it’s vital to understand that tobacco dependency is an illness that requires urgent treatment.

The reports main finding outline:

  • In England there was a 75% decline in the number of stop smoking aids dispensed in 2016- 17 compared with 2005-6.
  • Scotland saw a 40% drop in stop smoking aids prescribed, while in Wales, the number of all stop smoking products dispensed in 2016-17 fell to just a third of what was dispensed in 2007-08.
  • Regional variation of CCG prescribing levels is huge. There are many areas where prescriptions are extremely low, even in areas with high numbers of smokers.

The local authority in Worcestershire fully decommissioned its stop smoking services in April 2016. Neighbouring CCGs then advised that ‘no prescriptions’ for nicotine patches, gum, lozenges and sprays should be written for new patients.

The impact of decommissioning services and advising GPs not to prescribe stop smoking aids is that the number of items prescribed through primary care in each CCG has plummeted in the area.

For patients in the City of York, services are only open to those who are in a priority group. GPs have been asked to not prescribe due to cost implications for the CCG. The free NRT voucher scheme in the area was also stopped. This leaves some smokers without any route to support.

The British Lung Foundation explains that the future sustainability of the NHS is connected to the success or otherwise of services that exist to keep people healthy and prevent people developing long term conditions.

Alison Cook, Director of Policy for the British Lung Foundation, said:  “People who smoke are likely to be high users of NHS services. Decommissioning the prescribing of stop smoking aids will only achieve short-term savings. Worryingly, it will shore up a greater burden on the NHS in the long run in terms of hospital admissions and the impact on already stretched A&E services. The decisions are foolhardy and must be reversed.

“It’s obvious cost pressures in local authorities are due to cuts from central Government and the main reason these vital services are vanishing. NICE guidance is clear that all smokers should have access to specialist services where they can receive clinically-effective support based on their own needs and preferences.”

The new BLF analysis shows this simply isn’t happening. Smokers are discriminated against depending on where they live due to the commissioning choices made by local NHS bosses.

All smokers should be able to expect their GP to provide access to stop smoking medication, either by prescribing themselves or by referral to a specialist service. This includes patients who want to quit but aren’t in a priority group.

The report recommends

  • The UK government reverses the cuts to public health funding for local authorities.
  • Commissioners of stop smoking services remove from contracts any unfair restrictions on which, and how many, approved stop smoking products can be prescribed.  
  • The Scottish government maintains its commitment to sustainable funding of stop smoking services in its new Tobacco Control Strategy.

Cook continued, “CCGs should immediately retract all guidance to GPs which withdraws their right to prescribe stop smoking medications. We are making a big mistake as these services could potentially save an NHS immersed in financial difficulties, millions.”

Links

https://www.blf.org.uk/

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