Letter to patients who need a positive diagnosis of coeliac disease and get GFF on prescription Dear xxxx (patient) NHS Vale of York Clinical Commissioning Group (CCG) is responsible for commissioning your healthcare. Commissioning in the NHS involves making decisions about local need, the allocation of resources, the purchasing of services as well as their monitoring and review. The CCG has a duty and responsibility to commission safe and effective services that deliver the best affordable care within the resources available. As part of its review of the prescribing process in the Vale of York, the CCG has recently analysed the prescribing of gluten free foods for patients diagnosed with coeliac disease. The analysis was based upon guidance from the National Institute for Health and Care Excellence (NICE) and local prescribing information. The guidance states that in order for patients to be diagnosed as having coeliac disease they must have a recognised blood test and a biopsy of the gut. It appears that some people in the Vale of York have been diagnosed as having coeliac disease without a biopsy to confirm the diagnosis, therefore potentially restricting the patient’s diet unnecessarily. As your diagnosis of coeliac disease was based upon the results of a blood test. It is important to make sure that you are diagnosed with coeliac disease by doing a biopsy. The biopsy is also necessary to be prescribed with gluten free foods.* What happens next? If you would like to have the biopsy that will confirm your diagnosis, please contact the surgery so we can organise this. Please bear in mind that you will have to resume a ‘normal’ diet (containing gluten) in the short term prior to the biopsy test. If you do not want to undergo this procedure, it will not be possible to confirm a diagnosis of coeliac disease and this will affect your eligibility to receive gluten free foods on prescription in the future. Gluten free foods on prescription* Prescribing without a biopsy may mean that patients are unnecessarily restricting their diet. It can also lead to unnecessary prescribing spend. The CCG has reviewed the prescribing of gluten free food in other areas and used this information to shape its decision to limit gluten free prescribing to bread and flour from the 1 September 2014. Other gluten free products will no longer be available on prescription. Please see the recommended amounts of units prescribed below. (NB: A 400g loaf of bread accounts for 1 unit and 500g bread flour accounts for 2 units) To be referred for a biopsy please contact Dr xxxx at the surgery. If you have any queries about this change in prescribing, please contact valeofyork.contactus@nhs.net Recommended amounts per month: Yours sincerely xxxxxxxx Age and sex child 1-3 years child 4-6 years child 7-10 years child 11-14 years child 15-18 years male 19-59 years male 60-74 years male 75+ years female 19-74 years female 75+ years Higher level of physical activity (any age or sex) breastfeeding 3rd trimester pregnancy Number of units 10 11 13 15 18 18 16 14 14 12 add 4 add 4 add 1