Keeping Specialist Infant Formulas on Prescription
The BDA believes that breastfeeding is best for babies.
Clinical Commissioning Groups (CCGs) across the UK are under huge pressure to save money that can be ploughed back into primary care services. Many are looking at changing or reducing the products and medicines that they provide as a means of producing those savings.
A small number of CCGs have taken the decision to remove infant formulas from prescription. While some of these products, such as lactose-free formulas and thickeners are available from supermarkets and over the counter from pharmacies, many of the more specialised formulas are not readily accessible.
Broadly speaking, the BDA believes that specialist formulas should be maintained on prescription, as they are important to the ongoing nutrition and wellbeing of infants. If those formulas are not available commercially, it is essential that they remain on prescription.
In some worrying cases, it appears that CCGs have confused Cow's Milk Protein Allergy (CMPA) with lactose intolerance. CMPA is a highly complex food allergy which can affect the skin, respiratory and gastrointestinal systems, and cannot be treated with lactose-free formulas. The specialist formulas that are used to treat CMPA are only available on prescription.
What the BDA is doing
Where the BDA becomes aware of any proposal to remove specialist formulas, we will be working with colleagues from Allergy UK, the British Society for Allergy and Clinical Immunology (BSACI) and others to set out our opposition to such a change. This may include responding to the consultation and writing directly to the CCG concerned. Allergy UK has also sent out Freedom of Information requests to all CCGs in England, with the aim of mapping which have made changes, which might be planning to and which have no plans to do so.
If we can support a CCG by providing more information or training to help them prescribe these formulas more effectively and efficiently we will endeavour to do so.
In particular, we will seek to prevent the removal of formulas which are not widely available for purchase from commercial outlets.
We have also worked with BSACI and Allergy UK to raise this issue with the Department of Health and NHS England, who we hope will provide guidance to CCGs so that these essential formulas are not removed from prescription.
What we need members to do to help
If you are aware of your local CCG consulting on proposals to remove specialist formulas from prescription, please get in touch with the external affairs team to let us know so that we can respond.
We would also encourage you to respond to any such consultation yourself, and have included information in the section below that might be useful in shaping your submission. If you treat patients that are directly affected by these changes, we would recommend that you also encourage them to respond to the consultation to set out how the changes will affect them.
Tools and other information
- The BDA, BSACI, Allergy UK and RCPCH have created a briefing outlining our collective concerns on this issue which can be read here.
- Richmond CCG have reversed their decision to remove specialist formulas and will be developing new guidelines and education for GPs on allergy.
- We're pleased that Kingston CCG also reversed their decision to remove specialist infant formulas thanks to our joint efforts with BSACI, Allergy UK and the RCPCH.
- Read the BDA, BSACI and Allergy UK's joint letter to Croydon CCG opposing its proposed changes to infant formulas - we have since been pleased to see that the decision to remove CMPA formulas has reversed.
- Read the BDA, BSACI and Allergy UK's joint letter to the Department of Health and NHS England to raise concerns about proposals in Croyden and Richmond CCGs.
- Read the BDA, BSACI and Allergy UK's joint letter to Worcestershire CCGs and MPs following their decision to consult on removing infant formulas from prescription.
- Take a look at the NICE Clinical Knowledge Summary for Cow's Milk Protein Allergy in Children.
- Read Allergy UK's thoughts on the Richmond CCG consultation.
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