​Low Value Medicines and Self Care - Guidance for Patients

Low value medicines

NHSE issued guidance in November 2017; 'Items which should no longer be routinely prescribed in primary care'. The result of this guidance is that South West London (SWL) Clinical Commissioning Groups (CCGs) (NHS Croydon, NHS Kingston, NHS Merton, NHS Richmond, NHS Sutton and NHS Wandsworth) have recommended NHS prescribers stop or greatly reduce the prescribing of the medicines in the guidance from December 2017. This is because they are:

  • Not as safe as other medicines OR
  • Not as good (effective) as other medicines OR
  • More expensive than other medicines that do the same thing OR
  • Shouldn't be available on the NHS in some circumstances.

What medicines are included in this change?

NHS England guidance recommends that the following medicines or treatments should not be prescribed any more or should only be prescribed in special circumstances. They are:

AliskirenAmiodaroneBath and shower preparationsCo-proxamol
DosulepinDoxazosin MRDronedaroneImmediate release fentanyl
Glucosamine and chondroitinHerbal treatments and homeopathyLidocaine plasterLiothyronine
Lutein and antioxidantsMinocycline for acneInsulin needles >£5 per 100 needlesOmega 3 Fatty Acid Compounds
Oxycodone and naloxone combination productsParacetamol and tramadol combination productsPerindopril arginineRubefacients (excluding topical NSAIDs and capsaicin)
Silk garmentsOnce daily tadalafilTravel vaccinesTrimipramine


Self care

SWL CCGs are committed to delivering best value by ensuring that we use our resources well. To help us to support the implementation of the NHS England guidance 'Conditions for which over the counter items should not routinely be prescribed in primary care' (March 2018), SWL CCGs no longer support the routine prescribing of health supplements and medications that can be bought over the counter for minor conditions, self-limiting and short-term illnesses. For the SWL position statement please click here. Exemptions to the guidance are shown here.

For a leaflet on the NHS England self care and over the counter prescribing changes please click here.

Please remember:

  • The NHS recommends everyone keeps a well-stocked medicine cabinet with self-care medicines. Find out more here.
  • Community pharmacists can offer advice on how to manage short term illnesses and minor conditions, when to seek medical advice, and what to take if you take other medications. You do not need to make an appointment to see the pharmacist, and many pharmacies are open late nights and at the weekend.
  • If your problem is more serious and needs the attention of another healthcare professional such as a GP, the pharmacist will advise on this.
If your problem is more serious and needs the attention of another healthcare professional such as a GP or Optometrist the pharmacist will advise on this.

If your child needs to have medicines in school, please click here.

For further information, please visit: 

Aliskiren patient information leaflet.pdf
Amiodarone patient information leaflet.pdf
Bath and shower preparations patient information leaflet.pdf
Conjunctivitis support slide V1.pdf
Constipation support slide V1.pdf
Co-proxamol patient information leaflet.pdf
Dosulepin patient information leaflet.pdf
Doxazosin patient information leaflet.pdf
Dronedarone patient information leaflet.pdf
Dry and sore tired eyes V1.pdf
Dry skin Self care PIL V1 January 2020.pdf
Ear wax support slide V1.pdf
General exemptions to the national OTC guidance.pdf
Glucosamine patient information leaflet.pdf
Haemorrhoids support slide V1.pdf
Hay Fever Self care PIL final April 2019.pdf
Hay fever support slide V1.pdf
Herbal treatment patient information leaflet.pdf
Homeopathy patient information leaflet.pdf
Immediate release fentanyl patient information leaflet.pdf
Indigestion and heartburn support slide V1.pdf
Lidocaine plaster patient information leaflet.pdf
Liothyronine patient information leaflet.pdf
Lutein and antioxidant supplements patient information leaflet.pdf
Medicines in Nurseries and Schools.pdf
Mild Dry Skin support slide V1.pdf
Minocycline patient information leaflet.pdf
Mouth ulcers support slide V1.pdf
Nappy rash support slide V1.pdf
Needles for insulin pens patient information leaflet.pdf
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