Welcome to our survey
 
This survey is being run by the NHS Bristol Clinical Commissioning Group (CCG).
 
We are reviewing our approach to gluten free food prescribing in Bristol and we want to hear people’s views before we make any decisions.

The survey is open from Monday 22 January until 15 April and after this we will publish a report on the Bristol CCG website summarising all the feedback received.
 
Background

For the past 40 years, the NHS has provided gluten free (GF) food on prescription to patients diagnosed with coeliac disease. This started because GF products were not easily available in the shops and were much more expensive compared to non-GF foods. In recent years however, awareness of coeliac disease has increased and the range of GF foods available in the shops has increased, while their prices have gone down.  

Clinical Commissioning Groups (CCGs) are the organisations responsible for planning and buying NHS services in a local area. All GP practices are members of their CCG and they work together to make sure that the patients in their area have the services they need. The NHS has a limited budget and there is increasing demand for services, which means that we must   regularly review the services we pay for to make sure they offers good quality, value for money and are a fair way of using our resources.

The consultation invites you to share your views on options to reduce Bristol CCG’s yearly GF food prescribing costs, which currently stands at approximately £156,000 per year.​ Our preferred option is to stop prescribing to people aged 18 years and over, while offering a limited list of “staple” foods (such as bread and pasta) to people aged under 18. 

We would like to hear your views on this proposed change, whether you are a patient living with coeliac disease or not.

What is coeliac disease?
Coeliac disease is a disease where a protein, called gluten, which is found in wheat, barley and rye, causes the body’s immune system to react to gluten and damage the surface of the small intestine. This disrupts the body’s ability to absorb nutrients from food. It is a serious, lifelong condition, and the only way to reverse the damage and prevent further damage is to remove gluten from the diet.

Currently, the NHS pays for GF foods for people who have been formally diagnosed with coeliac disease or dermatitis herpetiformis (a skin condition linked to coeliac disease). When gluten-free foods were first available on the NHS, there was very limited availability of these alternatives in shops, and what was available was much more expensive than the gluten-containing products. 

Today there is much wider availability of these foods, not just in larger supermarkets but also in the discount supermarkets. This has increased choice and reduced prices. As the NHS must pay for these foods through the same process as prescription medicines, the cost to the NHS is now much higher than the cost in the supermarkets.
 
Survey questions:

* 1. Which of the following applies to you? (tick as many as apply)

* 3. What is the first half of your postcode? (e.g BS1 or BS16)

* 4. Do you currently receive gluten free foods on prescription? If no, go to Question 8

* 5. How often do you get a prescription for GF foods?

* 6. Why do you choose to obtain GF food on prescription? (tick as many as apply)

* 7. Which GF foods do you receive on prescription (tick all that apply)

* 8. Why do you choose not to obtain GF food on prescription?

* 9. Please select the ONE option below you agree with the most

* 10. Below is a list of statements. Please indicate how much you agree or disagree with each statement.

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
I understand the reason that the CCGs are reviewing GF foods on prescription.
I think It is appropriate that the NHS provides GF foods on prescription.
I think that not prescribing GF foods will make it harder to follow a GF diet.
I think that GF foods in supermarkets are affordable.
I think that GF foods are readily available and easy to find in your area.
I think that there is enough information and support available for people to manage their diet and condition.
I support the CCGs preferred option to stop prescribing GF foods to people aged 18 years and over.

* 11. Do you have any other comments?

The information you provide below will help us improve the health of the whole local population. All information you provide will be treated anonymously and with utmost confidence.

* 12. Age

Disability

* 13. Do you consider yourself disabled?

* 14. It helps us to know whether we are reaching all disabled people. Please can you tick the relevant impairment (disability) group below, and you are welcome to tick more than one box if appropriate:

Gender reassignment

* 15. Have you gone through a gender reassignment process or do you intend to?

Pregnancy and Maternity

* 16. Are you pregnant, or have you given birth in the last 26 weeks?

Race

* 17. What is your ethnic group?

Religion and Belief

* 18. Do you have a Religion or Belief?

* 19. If yes, are you?

Sex

* 20. Are you:

Sexual Orientation

* 21. What is your sexual orientation

Thank you for taking the time to give us your feedback. After the survey has closed, we will publish a report on the NHS Bristol CCG website summarising all the feedback received.
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