Coeliac Disease: Gluten-free Foods

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, to ensure consistency of approaches between ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practices.

NHS England’s guidance on Prescribing Gluten-Free Foods in Primary Care states that commissioners restrict the prescribing of gluten free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end the prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.

The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.