TEMS not routinely prescribed in primary care

Last year 21.6 million prescription items were dispensed for patients covered by the Birmingham and Solihull Clinical Commissioning Group (CCG) at a cost of £185 million. The policy for items which should not routinely be prescribed in primary care will help us to make sure that we make wise use of NHS prescribing resources for the benefit of everyone.

This policy sets out the CCG’s position on 18 products previously available on NHS prescription in Birmingham and Solihull, each of which falls into one of the following categories:

• Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness, or there are significant safety concerns
• Products which are clinically effective but where more cost-effective options are available, including products which have been subject to excessive price inflation
• Products which are clinically effective, but due to the nature of the product, are deemed low priority for NHS funding

It is based on the NHS England/NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs, and covers the following products:

• Co-proxamol
• Dosulepin
• Glucosamine and chondroitin
• Herbal treatments
• Homoeopathy
• Immediate release fentanyl(not fentanyl patches)
• Lidocaine plasters
• Liothyronine
• Lutein and antioxidants
• Once daily Tadalafil
• Omega-3 fatty acid compounds
• Perindopril arginine
• Prolonged release doxazosin
• Rubifacients(excluding topical non-steroidal anti-inflammatory drugs – NSAIDs)
• Targinact – Oxycodone and naloxone combination product
• Tramacet – paracetamol and tramadol combination product
• Trimipramine
• Vaccines administered exclusively for the purposes of travel

The policy sets out more information regarding the approach to each of the products and you can also find out more by reading the patient information above.

GP practices will no longer start new prescriptions for these products and, over the coming months, will be reviewing patients already receiving prescriptions. As always, they will use their clinical skills and judgement in caring for individual patients, whilst making best use of NHS resources for the benefit of all patients. Practices will be contacting patients in due course, and there is no need to make an appointment before this unless you have concerns over your condition.

CCGs have limited budgets which are used to commission healthcare that meets the reasonable requirements of their patients. This policy helps us to prioritise resources using the best evidence about what is clinically effective, to provide the greatest proven health gain for the whole of the CCG’s population. Our intention is to ensure access to NHS funding is equal and fair, whilst considering the needs of the overall population and evidence of clinical and cost effectiveness.