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Over-the-counter medicine

Over-the-counter medicines policy

Patients with minor conditions where the medication is readily available over-the-counter (OTC) in pharmacies or supermarkets will no longer receive prescriptions for those treatments.

Instead they will be advised which treatments or medication to purchase by their GP, Nurse or community pharmacist, as these items are often cheaper to buy directly when compared to the cost of a prescription. 

This will primarily affect medications such as paracetamol, throat lozenges or vitamins, and conditions such as cystitis or dandruff.

Any patients using OTC medications as part of the management or treatment of a more long-term condition will continue to receive it on prescription. 

Find out more about what this means for patients in our FAQs below, or on the policy FAQs available as a downloadable document.

What are self-limiting conditions/minor ailments

Self-limiting conditions are illnesses or conditions which will either resolve themselves without medical intervention, or which have no long-term harmful effect on a person's health. Minor ailments are uncomplicated conditions which can be diagnosed and managed without medical intervention. Examples of these are: sore throats, dandruff, infant colic, indigestion etc.

Why have you stopped funding medicines available to treat these conditions

Manx Care is keen to support patients in managing their own self-limiting conditions and minor ailments, which do not need to be treated by a doctor. Patients are able to purchase such medicines after seeking appropriate advice from a community pharmacist or other healthcare professional, and by not requiring an appointment to access treatment and advice, the availability of GP appointments for patients with more serious conditions will be increased.

Often it is more expensive for Manx Care to supply OTC Medicines than for people to buy them themselves. Money saved from doing this will be re-directed towards treating serious conditions such as diabetes, cancer and heart disease.

OTC medicines are not as expensive as you may think. Painkillers such as paracetamol are widely available in pharmacies and supermarkets and may cost as little as 1p per tablet compared to 3p per tablet for Manx Care. When you only need them now and again, it is better to buy over the counter instead.

Some OTC medicines do not have a strong body of evidence to support prescribing them. Cough syrups, for example, may ease symptoms, but equally simple home remedies such as ‘honey and lemon’ work just as well, rather than paying for cough syrups.

If the medicines you are requesting are not on the pre-approved list of medicines across the Isle of Man for prescribing (called the Formulary), your GP may not prescribe them and you should purchase them over the counter.

Are there no other ways in which the NHS could save money

By prioritising how we use our services and when we use prescriptions, we will be able to better manage continuing cost pressures.

In general, these OTC medications are low-cost items easily available for purchase and stopping prescribing saves not just the cost of the medicines themselves but also Manx Care’s costs throughout the entire process:

  • Professional costs and time of GP/nurse to generate the prescription 
  • Professional costs and time to dispense the medicines
  • Transportation costs for completed prescriptions to be sent to pharmacies

We are committed to providing healthcare which is based on clinical need and getting the best outcomes for patients based on clinical evidence.  By increasing access to health care advice by asking patients to use community pharmacies for minor conditions we will be supporting our ambition to build a truly integrated health care system based on providing the ‘right care, at the right time in the right place’.

What are the conditions impacted by the policy

Policy No.Items of low clinical effectiveness
1 Probiotics
2 Vitamins and Minerals
Policy No.Self-Limiting Conditions
3 Acute Sore Throat
4 Infrequent cold sores of the lip
5 Conjunctivitis
6 Coughs and colds and nasal congestion
7 Cradle Cap (Seborrhoeic dermatitis – infants)
8 Haemorrhoids
9 Infant Colic
10 Mild Cystitis
Policy No.Minor Conditions Suitable for self- care
11 Mild Irritant Dermatitis 25 Sun Protection
12 Dandruff 26 Mild to Moderate Hay fever/Seasonal Rhinitis
13 Diarrhoea (Adults) 27 Minor burns and scalds
14 Dry eyes/sore tired Eyes 28 Minor conditions associated with pain, discomfort and/or fever. (e.g. aches and sprains, headache, period pain, back pain)
15 Earwax 29 Mouth ulcers
16 Excessive sweating (Hyperhidrosis) 30 Nappy Rash
17 Head Lice 31 Oral Thrush
18 Indigestion and Heartburn 32 Prevention of dental caries
19 Infrequent Constipation 33 Ringworm/Athlete's foot
20 Infrequent Migraine 34 Teething/Mild toothache
21 Insect bites and stings 35 Threadworms
22 Mild Acne 36 Travel Sickness
23 Mild Dry Skin 37 Warts and Verrucae
24 Sunburn due to excessive sun exposure

If you are no longer prescribing these medicines, where can I get them

Medicines can be purchased at low cost from community pharmacies and/or supermarkets, and many people already do this when they need them. The evening and weekend accessibility of many shops gives you rapid access to treatment, rather than delaying treatment by requiring a GP appointment (telephone or face to face) for a prescription.

The range of medicines available over the counter increases regularly and a community pharmacist is best placed to give advice on the most appropriate product to use. Shops and supermarkets will have a more limited range of these products that you can purchase.

Community pharmacists train for a minimum of five years in the use of medicines and are trained in managing minor illnesses too. They can offer clinical advice and provide medication for a range of minor ailments and common conditions, as well as provide advice on how best to keep you and your family healthy and well. Pharmacists will always advise patients with ‘red flag symptoms’ to access more appropriate and urgent medical care and similarly, if symptoms are not improving or responding to treatment, they will be encouraged to seek further advice.

You may find it helpful to keep a small supply of medicines at home for use such as painkillers for headaches and anti-allergy cream for bites or stings. Buying ‘own brand’ or generic items may be more cost effective than branded products.

I need this medicine for my child, can I have it on prescription

It is expected that all patients, regardless of age, should be able to access or purchase such medicines for minor conditions. In the case of children, the parent/guardian/carer is responsible for providing it.

Prescriptions will still be available when a product licence doesn’t allow the product to be sold over the counter - for some children’s products or specific strength items.

I am being treated with these medicines for a long-term medical condition and taking them regularly. Do I need to purchase them

Where an OTC medicine is being used as part of a complex combination of medicines to manage a long-term condition, and the GP is helping you to monitor the combination, then it may be prescribed at the GP’s discretion. 

For example:

Paracetamol for short-term pain relief and headaches should be purchased, but paracetamol used in long-term management of chronic pain (regularly needing two tablets four times a day) may be prescribed

Creams/emollients for minor dry skin conditions should be purchased but can be prescribed where there is a clinical skin diagnosis.

Where you are able to purchase these yourselves you will be helping the NHS by doing so.

Hay fever/allergic rhinitis is not a long-term medical condition and treatment is generally required for a few months each year so it can be managed without medical input.  Chronic sufferers will be able to access prescription-only medicines where required.

I have a medical exemption certificate. Can I have the medicine on prescription

We are asking all patients across the Island to purchase medicines for their own self-limiting conditions and minor ailments. This includes patients with medical exemptions for a medical condition, maternity or age.

Self-limiting conditions are illnesses or conditions which will either resolve on their own or which have no long-term harmful effect on a person's health. Minor ailments are uncomplicated conditions which can be diagnosed and managed without medical intervention. These conditions are usually unrelated to the condition for which you have medical exemption and so should be purchased rather than prescribed.

I have been to my pharmacy to buy a medicine but they will not sell it to me. What do I do

There will be some situations where a pharmacist feels it would not be appropriate to sell you a medicine, based on the information you provide and on their professional judgement. If this is the case the pharmacist should explain why, and advise on what you should do.

My Pharmacist has told me that my child has conjunctivitis. I have been advised to buy eye drops to treat this condition. Can my nursery administer these if my doctor hasn’t prescribed it

Medicines that you can buy without prescription (over the counter medicines) do not require any written consent from a GP or other healthcare professional to allow nursery (or other childcare provider) staff to administer them, providing the medicine is being used for the reasons described in the patient information leaflet, and at the recommended dose on the package for the age of the child.

Medication may only be administered to a child under the age of 16 by a nursery or other childcare provider (including schools) where written permission and consent has been obtained from the child’s parent/guardian or carer.

The Department of Education, Sport and Culture (DESC) provides guidance on the administration of medicine and medical care in schools

Who can I contact if I have further queries regarding this policy

For queries regarding the policy decision please contact the DHSC on or call +44 1624 685816.

For any other queries about access, how the policy is being applied, or general OTC guidance please contact the Manx Care Advice and Liaison Service (MCALS) on or by calling +44 1624 642642.

More information about MCALS is available online.

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