BDA respond to launch of Department of Health consultation on removing gluten free foods on prescription31 March 2017
The Department of Health has today launched a formal consultation1 on possible changes to the availability of gluten free foods on prescription. The British Dietetic Association (BDA) will be submitting a robust consultation response to argue that the NHS should continue to provide staple gluten-free products for those vulnerable patients such as children, elderly and those least able to afford commercial gluten free products.
The BDA, founded in 1936, is the professional association for dietitians in Great Britain and Northern Ireland. It is the nation’s largest organisation of food and nutrition professionals with over 8,500 members. The BDA is also an active trade union.
Coeliac disease is a lifelong autoimmune condition to which the only effective treatment is lifelong adherence to a gluten-free diet. Children’s development and growth could seriously be impaired by not having access to gluten free products on prescription, which will then impact on micronutrient deficiencies.
The impact of removing these products from prescription will have the greatest effect on the most vulnerable. The NICE Quality Standard on coeliac disease2 recognises that "gluten-free products are more expensive and are usually only available from larger retailers, making access more difficult for people on low incomes or with limited mobility. As coeliac disease can affect more than one member of a family it can also be an additional burden on the family budget.”
The Department and NHS England must also be mindful of the long-term health consequences of poor adherence to a gluten free diet by patients with coeliac disease. The possible complications of the disease are very significant and include depression, infertility, anaemia, osteoporosis, osteopenia and some cancers. It is counterproductive to try to save a relatively small amount of money from prescriptions only to see a significant increase in the financial burden from serious long-term complications of the disease.
Lisa Vokes, Chair of the BDA Gastroenterology Specialist Group said: “A complete removal of gluten free products from prescription is not the answer. There are alternative models that could be implemented, such as pharmacy led schemes or voucher schemes with regular reviews with a dietitian. Placing dietitians at the heart of the process can improve effectiveness and efficiency while maintaining an appropriate standard of provision for patients. Dietitians are experts in nutrition and therefore the best-placed healthcare professionals to lead on effective and efficient nutritional care.”
Patients with coeliac diseases should receive a regular - at least annual - review with a dietitian to ensure they are able to maintain a gluten free diet. At an annual review, dietitians can assess and advise on diet including the best ways to use foods naturally low in gluten as well as the effective use of prescribed gluten free foods. It is vital that patients with coeliac disease continue to have access to this support in future.
The BDA will continue to work with colleagues and partners including Coeliac UK to make the case for keeping gluten free products on prescription.
Notes to editor:
• Dietitians are the only qualified health professionals that assess, diagnose and treat diet and nutrition problems at an individual and wider public health level. Uniquely, dietitians use the most up to date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices.
• Dietitians are the only nutrition professionals to be statutorily regulated, and governed by an ethical code, to ensure that they always work to the highest standard. Dietitians work in the NHS, private practice, industry, education, research, sport, media, public relations, publishing, non-government organisations and government. Their advice influences food and health policy across the spectrum from government, local communities and individuals.
• Visit the BDA website: www.bda.uk.com
• Find us on twitter: @BrDieteticAssoc