Gluten-free foods prescribing

The prescribing of gluten-free foods in Leicester, Leicestershire and Rutland (LLR) is ending from 1 February 2025.

The LLR Integrated Care Board (ICB) took the decision at its meeting on 12 December 2024, following a lengthy consultation process and discussions with patient representative groups and clinicians including GPs, dietitians and pharmacists. The consultation attracted 1,468 responses. The full Report of Findings is published on our website.

These changes are happening for a few reasons:

The availability of gluten-free foods used to be limited, therefore foods were made available through a prescription. These products are now more widely available in some supermarkets and online.
Awareness of Coeliac Disease and Gluten intolerance has improved and there is a general trend towards eating less gluten, so these foods have become more accessible in some supermarkets and online.
Better labelling on foods means that people are better able to see whether ordinary foods are free from gluten.
While gluten-free food is still more expensive than equivalent products containing gluten, the price paid by the NHS for gluten-free foods on prescription is still much higher than the supermarket or online prices.

We appreciate the impact this may have on you or your family, however the local NHS has carefully considered health spending on gluten-free products along with support for all conditions, balancing it with the clinical risk and patient needs.

The ICB Board recommended that additional support should be put in place for patients following diagnosis of coeliac disease and/or dermatitis herpetiformis, including advice and guidance on diet, lifestyle and staying healthy.

Coeliac disease is a condition where the immune system damages the gut when gluten is eaten. Dermatitis herpetiformis is a skin condition linked to coeliac disease.

The ICB decision will save the NHS more than £250,000, at a time of significant financial pressure on the health service. This move within LLR is in line with other parts of the East Midlands that have taken similar decisions to remove gluten-free food prescribing.

Frequently asked questions

Questions about the ending of gluten-free food on prescription are answered here.

NHS support available

For children and young people under the age of 16

Support is provided by the University Hospitals of Leicester (UHL) dietetics department, with consultant gastroenterologist input if there are any concerns. Patients are seen on an individual basis to support with dietary/lifestyle changes. Children are usually discharged back to their GP once they reach 16 years.

Resources provided include:

Coeliac UK – ‘coeliac disease and me’ booklet
Coeliac UK school pack
UHL coeliac disease in children leaflet
Information on dietary calcium and iron intake
Leicester City Council / Leicestershire County Council school meals form (if applicable)
Leicestershire Coeliac UK group flyer
Free sample cards for various gluten-free brands and product

For further information on referral, diagnosis and support, please visit the UHL website.

For young people aged 16-18 years

Young people are occasionally seen on a one-to-one basis by Leicestershire Partnership NHS Trust’s (LPT) paediatric dietetic team in the community every six months and then annually once a strict gluten-free diet has been established by the family.

Appointments cover topics such as what coeliac disease is, where gluten is found, and principles of a gluten-free diet.

An information pack is provided on coeliac disease, sample order forms for coeliac products and information on Coeliac UK.

For further information on referral, diagnosis and support, please visit the LPT website.

For adults over the age of 18

The Leicestershire Partnership NHS Trust (LPT) primary care dietetic service offers a virtual group education session for those who are newly diagnosed with coeliac disease. One-to-ones are offered in certain cases. Referral into the sessions is via a GP. Sessions are run monthly, and the waiting time is usually six-to-eight weeks following diagnosis. In the interim, patients are sent advice and a link to an online video.

The sessions last one-and-a-half hours and cover practical tips on:

How to avoid food containing gluten and choosing healthy alternatives
Eating out
Contact numbers for Coeliac UK, their local network group, and the dietetic team.

For further information on referral, diagnosis and support, please visit the LPT website.

Gluten-free options on school menus

The decision to end the prescribing of gluten-free foods does not affect the provision by local authorities for children who require a gluten-free diet at school. Both Leicester City Council and Leicestershire County Council state there is adequate provision for children who require a gluten-free diet at school. It is a legal requirement for schools in England to support children with medical conditions.

Gluten-free options in care homes

According to the Care Quality Commission (CQC):

People in residential care settings must have their nutritional needs assessed and food must be provided to meet those needs. The assessments should follow nationally recognised guidance and identify any dietary intolerances
Where a person is assessed as needing a specific diet, this must be provided in line with that assessment
Providers must include people’s nutrition and hydration needs when they make an initial assessment of their care, treatment and support needs, and in the ongoing review of these. The assessment and review should include risks related to people’s nutritional and hydration needs
Providers should have a food and drink strategy that addresses the nutritional needs of people using the service.

Gluten-free options for people with learning difficulties and/or autism

The local learning difficulties and/or autism team will be able to work with individuals on changes to gluten-free foods on prescription. During the annual review with individual patients, they will be able to establish whether there is a need for further dietetic support. Patients with learning difficulties and/or autism receive annual health monitoring from their GP where this topic can be raised.

Gluten-free diet

When you are first diagnosed with coeliac disease, you will be referred to a dietitian to help you adjust to your new diet without gluten. They can also ensure your diet is balanced and contains all the nutrients you need.

If you have coeliac disease, you will no longer be able to eat foods that contain any barley, rye or wheat, including farina, semolina, durum, bulgar, cous cous and spelt.

Gluten is not essential in your diet and it can be replaced by other foods. There are many gluten-free versions of common foods such as pasta, pizza bases and bread available in supermarkets and health food shops.

Many foods, such as meat, vegetables, cheese, potatoes and rice, are naturally free from gluten so you can still include them in your diet. A dietitian can help you identify which foods are safe to eat and which are not.

The Coeliac UK website has information on having a gluten-free diet.

The Coeliac UK website has information on gluten-free recipes.

Questions and answers about what you can eat and drink, what you cannot eat and drink, and food labelling and ingredients are covered in the Coeliac UK website living gluten-free guide.

Understanding coeliac disease

The NHS website provides a range of information on coeliac disease. Its content covers symptoms, causes, diagnosis and treatment.

Top tips

The Association of UK Dietitians has factsheets to help people live well gluten-free.

Their top tips include:

Gluten-free bread sometimes tastes better baked or toasted; try several products as they do differ. Companies may give a sample pack for newly diagnosed patients to try
Use a separate margarine, nut butter or jam to reduce risk of cross contamination
Try using a toaster pocket if you’re using a toaster that is also used to toast gluten-containing bread
Try to go for naturally gluten-free foods to reduce the impact of the higher cost of gluten-free products
Take snacks or a packed lunch if you are not sure if there will be gluten-free options when you are away from home
Look for gluten-free nights at fish and chip restaurants – this is often when they change the cooking oil to prevent cross contamination
For eating out, call ahead and ask questions about how your food will be prepared. This will help you identify if your meal is truly gluten-free
For eating out, look out for the Coeliac UK GF accreditation – this means Coeliac UK has audited the venue’s processes to ensure they meet the required standard to offer safe gluten-free food and ensures the staff have been trained to understand coeliac disease and the requirements of the gluten-free diet
Discuss your diagnosis with friends and family (or your child’s school if your child is affected) so they can support a gluten-free diet
Join supportive groups such as coeliac local support groups in your area, coeliac groups online or via social media to get support and more information on travelling, or recipe ideas.

Other useful information

The BBC Good Food website also contains top 10 tips for a gluten free diet www.bbcgoodfood.com/health/special-diets/top-10-tips-gluten-free-diet

Patient Webinars are also available to view on Overview of Coeliac Disease – patientwebinars.co.uk

There is local advice and support available on the cost of living from local authorities:

Leicester City Council – Household support fund
Leicestershire County Council – Cost of living support
Rutland County Council – Cost of living support

If you require specific advice, please ask your GP if you can be referred to a dietitian.

If you have a general enquiry about the changes, you can:

Email: llricb-llr.beinvolved@nhs.net
Telephone: 0116 295 3405
Write to: Leicester, Leicestershire and Rutland Integrated Care Board, Room G30, Pen Lloyd Building, Leicestershire County Council, Leicester Road, Glenfield, Leicester LE3 8TB