NHS England has advised CCGs that a prescription for the treatment of infrequent constipation should not routinely be offered in primary care as the condition is appropriate for self-care. The NHS England guidance applies to short term, infrequent constipation caused by changes in lifestyle or diet such as lack of water or movement or changes in diet. GPs should continue to prescribe laxatives to manage acute constipation with more complex aetiology (e.g. iatrogenic) and chronic constipation.
The NHS England guidance does not apply to the management of children and laxatives for children should continue to be prescribed by GPs.
LSCMMG has granted interim approval for this position statement ONLY. LSCMMG is aware that each locality, prior to the establishment of the ICB, had adopted the 'Over the counter items that should not be routinely prescribed in primary care policy'.
Interim approval has been granted to provide consistency of advice to prescribers whilst the ICB considers whether to adopt the 'Over the counter items that should not be routinely prescribed in primary care policy' across Lancashire and South Cumbria.
Rheumatoid arthritis, severe psoriasis, severe active juvenile idiopathic
arthritis, severe psoriatic arthritis, mild to moderate Crohn’s disease
Unlicensed: Severe Eczema, Lichen Planus, Felty’s syndrome, severe Crohn’s disease
N.B. Not all brands/formulations are licensed for all indications – please refer to individual SPCs
Guidance on consensus approaches to managing Palliative Care Symptoms
Licensed: Rheumatoid arthritis; ulcerative colitis, Crohn’s disease in adults and children
Unlicensed: Sero-negative spondyloarthropathy including psoriatic arthritis and psoriasis.
Trans-anal Irrigation Systems are recommended for use within the Lancashire Health Economy for the treatment of Neurogenic Bowel Dysfunction and Non-Neurogenic Bowel Dysfunction including; chronic constipation and chronic faecal incontinence