'Unwarranted variation' in CCGs' gluten-free policy, study claims

A new study has identified “substantial clinically unwarranted variation” in rates of gluten-free food prescriptions in England, with CCG policy identified as a significant driving factor.

The study, published in BMJ Open, analyses trends over time and national variation in GF prescribing and considers factors that impact on the fluctuating prescribing rates seen in England.

Overall, GF prescribing is “declining rapidly,” the authors say, having risen between 1998 and 2010 and fallen thereafter.

The prescription of GF foods has been a talking point in recent years, and was included in NHS England’s consultation on ‘low value medicines’. Health charity Coeliac UK welcomed the eventual recommendation to maintain prescribing of staple foods such as breads and flour mixes. 

Diverse CCG policies

The researchers say that in England, CCGs, which are responsible for commissioning healthcare services, “currently have diverse prescribing policies” for GF products. These range from full adherence to national guidelines recommending the prescription of staple foods to “partial or complete withdrawal of prescriptions”. 

GP practices in the most deprived areas were found to be less likely to issue GF prescriptions than those in the most affluent areas.

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