NHS funding review: What prescriptions could be affected?
Video by ITV News reporter Rebecca Barry
Travel vaccinations, gluten-free foods and omega-3 supplements may no longer be available on the NHS under major cost-cutting plans.
Next month, NHS England is to launch a consultation on stopping GPs prescribing medicines which are available over the counter for a fraction of the cost, in a bid to save £128 million per year.
The new guidelines will be developed around a set of 10 medicines deemed ineffective, unnecessary or inappropriate for the NHS.
What could be affected?
Paracetamol
Sunscreen
Cough and cold treatments
Heartburn and indigestion tablets
Lidocaine plasters (for back or joint pain)
Fentinil (painkiller for cancer patients)
Travel vaccines that may no longer be available on the NHS:
Typhoid
Hepatitis A
Cholera
Triple jab for diphtheria, polio and tetanus
Prices for some of these travel vaccinations could range from between £30 and £50.
The travel vaccinations currently available on the NHS protect against diseases thought to represent the greatest risk to public health if they were brought into the country.
The consultation comes following a request by NHS Clinical Commissioners which identified "significant areas" where savings of up to £400 million per year could be made.
Around one in 100 people have coeliac disease,caused by a reaction to gluten, that can be treated by cutting the substance from a patient's diet.
Patients in most parts of the UK can receive gluten-free staple foods from a pharmacy through a prescription from a GP.
Foods currently approved for prescription include:
Bread or rolls
Breakfast cereals
Crackers and crispbreads
Flour and flour-type mixes
Oats
Pasta and pizza bases
A spokeswoman for NHS England said: "The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes."
However, charity Coeliac UK said it is "deeply disappointed" at the proposals to restrict NHS-prescribed gluten-free products.
The charity said not adhering to a gluten-free diet could lead to serious complications including osteoporosis, infertility and a few cases of bowel cancer, the charity said.
"I am very concerned that vulnerable and elderly patients today will be waking up to the headlines that prescriptions for the breads and flours that they rely upon as part of a healthy balanced diet will be removed in one fell swoop," said Coeliac UK chief executive Sarah Sleet.
The charity said that there is a six-fold difference in the price paid for a loaf of bread and gluten-free alternative.
But the NHS spends just 0.02% of its budget on gluten-free prescribing.
Labour's shadow health secretary Jonathan Ashworth criticised the move and said ministers need to explain what the proposals will mean for people eligible for free prescriptions:
"Of course, NHS bosses are right to demand the best possible value for money from the medicines they buy so that every penny can go towards patient care.
"But let's be clear: the greater restrictions and rationing proposed today are a direct result of Theresa May's under-funding of the NHS," said Mr Ashworth.
Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, warned that the move could alienate patients:
"Imposing blanket policies on GPs, that don't take into account demographic differences across the country, or allowing flexibility for a patient's individual circumstances, risks alienating the most vulnerable in society - and we will be seeking assurances from NHS England that this won't be the case."