Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will direct NHS England to update the guidance on gluten-free food prescriptions in the document entitled Prescribing Gluten-Free Foods in Primary Care: Guidance for Clinical Commissioning Groups, published on 28 November 2018.

NHS England currently has no plans to update the guidance. NHS England’s guidance on prescribing gluten-free foods in primary care was developed in 2018 to communicate to the then clinical commissioning groups (CCGs). The guidance stated that CCGs may further restrict the prescribing of gluten-free foods by selecting bread and mixes only, or that they may choose to end the 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 of reducing health inequalities.

Decisions about the commissioning and funding of local health services are now the responsibility of local integrated care boards (ICBs), rather than the CCGs. NHS England’s guidance should be taken into account 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 a 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 a prescriber and a patient, while also being mindful of local and national guidance.