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These are chronic inflammatory autoimmune diseases of the digestive system and skin caused by a reaction to gluten; a protein found in wheat, barley, and rye. There is no cure for these conditions, but following a gluten-free diet helps control symptoms and prevent long-term complications. More information is available on the NHS website.

To provide high quality medical care for as many people as possible, the NHS is constantly looking for ways to work differently, to ensure the best use of available NHS finances. NHS Dorset believes that this change will allow the better allocation of resources to meet the needs of the wider Dorset population and free up time, currently required for the generation of these prescriptions, for healthcare staff to provide other services. With a wide selection of gluten free products available for purchase they are no longer considered to be specialist; therefore, do not need to be issued on a NHS prescription, giving people freedom of choice.

• Increased availability: historically, gluten-free products were considered to be specialist products and were only available on prescription. In recent years, a increase in the range of gluten-free foods in supermarkets and online retailers has improved patient choice and made it possible to eat both a healthy and varied gluten-free diet.

• Access: 75% of Dorset patients with coeliac disease and dermatitis herpetiformis already self-purchase bread and flour mixes.

• Greater awareness: public awareness of coeliac disease and gluten intolerance has significantly increased demand which has helped to improve access to a wider range of gluten-free options in shops. It is also possible to eat a gluten-free diet without the need for specialist dietary foods. People can also choose naturally gluten-free carbohydrate-foods, such as rice and potatoes, as part of a healthy balanced diet.

• Improved labelling: clearer food labelling makes it easier for individuals to identify gluten-free products.

• Cost considerations: the cost of gluten-free bread and flour mixes available on prescription is significantly higher than those available in supermarkets and online. In addition to the cost of the prescription products themselves, the NHS pays the cost of processing the prescription items. This makes the price of gluten-free foods on an NHS prescription up to 4 times higher than buying it directly from a supermarket or online supplier. This change would also free up health care staff time to provide other clinical services.