NHS England is working on new guidelines to discourage GPs from prescribing medicines which are available over the counter for a fraction of the cost.

Here are some of the items available on prescription that are being considered as part of the consultation:

Gluten-free foods

Around one in 100 people have coeliac disease, caused by a reaction to gluten, that can be treated by cutting the substance from a patient's diet.

Once diagnosed as coeliac by a doctor, patients in most parts of the UK can receive gluten-free staple foods from a pharmacy through a prescription from a GP.

Foods approved for prescription include bread or rolls, breakfast cereals, crackers and crispbreads, flour and flour-type mixes, oats, pasta and pizza bases.

The amounts of gluten-free staple foods a sufferer can receive each month are controlled by the National Prescribing Guidelines.

Travel vaccines

Vaccines for typhoid, hepatitis A and cholera and a combined jab for diptheria, polio and tetanus are usually available free on the NHS.

The health service offers the vaccinations free of charge because they protect against diseases deemed to present the greatest risk to public health if brought into the country by travellers.

Some countries require visitors to be vaccinated against diseases such as yellow fever or meningitis prior to arrival, while travellers to some parts of the world are advised to have inoculations against a range of other diseases, including tuberculosis, hepatitis B, Japanese encephalitis and tick-borne encephalitis.

These are not usually available on the NHS and can cost around £50 for each dose.

Co-proxamol

Co-proxamol is used for mild to moderate pain relief is a combination of two active ingredients, dextropropoxyphene and paracetamol, which is typically included as a lower 350mg dose compared with the standard 500mg dose of paracetamol when taken alone.

There is limited evidence suggesting co-proxamol is more effective at treating pain than a regular dose of paracetamol, for either acute or chronic use.

There have been previous concerns that the drug has been linked to suicides and poisonings and it was gradually phased out from wide use between 2007 and 2007.

Omega-3 and fish oils Naturally-occurring oils from certain breeds of fish such as salmon and mackerel have typically been prescribed to promote a healthy heart for patients at risk of heart disease.

The fatty acid omega-3 usually comes in capsule form and has been used to help prevent irregular heartbeats and reduce the risk of clotting by making the blood less sticky.

Historic concerns about prescribing omega-3 stem from limited evidence suggesting the fatty acid is effective in capsule form, and little to categorically suggest what a recommended adult daily intake should be.

Other products highlighted include:

  • Suncream
  • Cough and cold remedies
  • Indigestion and heartburn medicines