Gluten-Free Food on Prescription Consultation Survey Results

Transcription

1 Gluten-Free Food on Prescription Consultation Survey Results Public Meeting November 22, 2016 Chair: Dr John Rivers, NHS Isle of Wight (IW) Clinical Commissioning Group (CCG)

2 Panel Dr John Rivers, NHS Isle of Wight (IW) Clinical Commissioning Group (CCG) Helen Shields, Chief Officer NHS IW CCG David Newton, Lay member Patient & Public Involvement, NHS IW CCG Governing Body Caroline Morris, Assistant Director, Corporate Business & Primary Care, NHS IW CCG

3 Agenda 6 pm Welcome & introduction (Chair John Rivers) pm Financial context (Chief Officer Helen Shields) 6:15-6:40 pm Consultation Survey results (Corporate Business & Primary Care Assistant Director, Caroline Morris) 6:40-7:00 pm Questions to the panel (All) 7:00-7:50 pm Group discussions on: Key topics raised during the consultation process on support needed & suggestions on how to manage the challenges faced (All) And a discussion on priorities for people/what s most important to get right (All) 7:50 pm Groups feedback three items. Next steps in the consultation process (8:30 pm Meeting latest close) (Chair John Rivers)

4 How we spend our allocation Continuing Care, 15m NHS support for Social Care 5m Community, 26m Other, 8m Running Costs, 3m Primary Care, 47m Mental Health, 24m Acute, 110m Acute care 46% Primary Care (prescribing) 12% Community 11% Mental Health 10% Primary Care (GPs) 8% Continuing Healthcare 6% Other programme costs 4% NHS support for Social Care 2% Running costs 1% 2016/17 budget of 238m Programme (healthcare) 235m Running costs 3m

5 Financial Position Year Growth m Allocation m Required out-turn Savings required to deliver out-turn m 16/17 2.8m (1.4%) 234m Break-even 6m (2.5%) 17/18 0.3m (0.2%) 233m Break-even 12m (5.4%) 18/19 0.1m (0.1%) 233m 0.5% surplus ( 1.2m) 11m (4.7%) Legal financial duty to meet required out-turn 16/17 spending 238m vs 234m allocation by using 15/16 surplus of c 4m Average national growth is 2% higher than CCG is receiving, as 11.9% over allocation target. By 18/19 CCG this will be 8.2% due to minimal growth Average national efficiency (savings) is 2%, so CCG requirement significantly higher

6 Response to Financial Position Reducing demand through: Prevention & early intervention schemes Reducing procedures of limited clinical effectiveness, unless exceptional criteria met e.g. cosmetic surgery Stopping or providing in other ways activity that doesn t add clinical value e.g. some follow-up out-patient appointments No new investment, without either new national funding or identifying savings to off-set the cost Redesigning the way in which services are delivered, to achieve good outcomes for less cost e.g. Mental Health Prioritising services and reviewing access thresholds

7 Consultation Survey Consultation ran September 22 - October 2. The proposal was: reduce allowance of gluten-free foods on prescription this year stop prescribing from April 2017 Over 400 people responded to the survey

8 Questions asked Fixed questions to find out about the specific views of the different groups of people who responded Open questions where people could write in their individual suggestions on: support needed for people with coeliac disease how to manage the NHS budget spent on this service

9 Respondent s Profile

10 Respondents with coeliac disease who use the prescription service

11 Bread & flour ordered the most

12 Average consumption is between 5 & 12 items ordered monthly

13 78.5% disagree with reducing/stopping & 15.8% agree with stopping

14 Comments We have had 100 s of comments and have grouped them into themes Foods are not readily available everywhere only large supermarkets however some said the opposite There are no medicines for coeliac disease so gluten-free foods should be supplied on prescription like medicines (widely held view of pensioners and mothers) Coeliac sufferers say that the service gives them a safe/approved supply of gluten-free food avoiding cross-contamination Many feel that the service helps compliance with a gluten-free diet and avoids serious health complications

15 Comments Perception is that Wightbread services provides food with added vitamins & nutrients to keep coeliacs healthy Others argue that foods for other conditions are not available on the NHS Wightbread service reduces the time GP s used to spend on prescribing these foods Enhance awareness of this disease so that GP's are more educated regarding the incidence especially in the elderly population

16 Comments Use naturally gluten-free alternatives/diet not prescriptions Reduce product list to basics only: bread, flour - some also quoted pasta & cereals as basics Pressurise supermarkets to reduce costs; get supermarkets to issue discount cards to people with coeliac disease Revert to old system whereby GP practice does prescribing CCG to reduce costs of administering service; put NHS service for gluten-free food supplies out to tender to reduce costs

17 Support requested Reduce prices of gluten-free foods in supermarkets at least three times more today Vs. ordinary food Set up a coeliac support group on the island to increase awareness and provide both dietary & medical advice Increase screening & early identification to reduce complications of going undiagnosed. Less than 50% people with coeliac disease on the island are diagnosed Reduce sugar & salt in gluten-free foods in general

18 Support requested Focus on helping most vulnerable coeliacs (pensioners, low income families, children) to make compliance affordable People in general feel that the service gives them a reliable supply to a variety of gluten-free foods especially important for children Continue access to safe, controlled gluten-free foods via service/ pharmacy Access to elderly without internet who can t travel far to big supermarkets, small stores don t stock pharmacy helps them order

19 Key topics for discussion Considering the pressures on NHS finances, is providing gluten-free foods the best use of our limited resources? If we stop prescribing gluten-free foods, how do we support elderly and vulnerable people to remain compliant with a gluten-free diet? If we do not remove all gluten-free products, should we limit the amount and type of products that are available? How can we improve the confidence of people in supermarket products?

20 Group sessions Please cluster into groups to discuss the following questions: Consider and debate the key topics. Is there anything else that the group would like to raise? Please identify three items you would like to feedback to the CCG today.

21 Next Steps Clinical Executive Committee to discuss and will make a recommendation to the Governing Body. The Governing Body will meet on the 22 December 2016 in public at Northwood House.

22 Meeting close Many thanks for coming this evening to share your comments. Our contact details: IW CCG Building A The APEX St. Cross Business Park Newport PO30 5XW Tel: (01983) ccg@iow.nhs.uk