Coeliac disease is a condition where the immune system attacks the body’s own tissues when gluten is eaten. This damages the gut (small intestine) so the body cannot properly take in nutrients.

The NHS website has lots of information on symptoms, causes, diagnosis and treatment.

The Coeliac UK website has lots of additional information.

Dermatitis herpetiformis is an autoimmune skin condition that can be linked to coeliac disease.

The NHS Inform website has lots of information on symptoms, causes, diagnosis and treatment.

The prescribing of gluten-free products for patients diagnosed with coeliac disease and dermatitis herpetiformis is changing.

From 1 August 2025, patients will no longer be able to receive gluten-free food on prescription.

This change is being introduced by the NHS Lincolnshire Integrated Care Board (ICB), the organisation that buys health services locally.

This change is happening for several reasons:

• The availability of gluten-free foods used to be limited; therefore, it was necessary that these foods were made available through a prescription. These products are now much more widely available in most 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 many 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 foods are relatively more expensive than equivalent products containing gluten, they have become more affordable for those who need them than they used to be.

Additionally, the price paid by the NHS for gluten-free foods on prescription is still much higher (up to four times higher) than the supermarket or online prices that individuals pay.

The NHS appreciates the impact this may have on patients; however, it has had to carefully consider health expenditure on gluten-free products, along with support for all conditions, balancing it with the clinical risk and patient needs.

It has been a difficult decision to make but it will save the NHS more than £240,000 per year, at a time when it is facing significant financial pressure.

A public consultation, held in spring 2025, attracted 428 responses with a significant number of people disagreeing with the proposal to stop providing up to eight units of gluten-free bread or flour on prescription to people diagnosed with these two conditions. Seventy two percent (72%) of the respondents had coeliac disease, dermatitis herpetiformis, or cared for someone who did.

Public consultation helps the NHS to understand the experiences of patients and the public and this feedback is then measured against other critical factors when it make a final decision on health services. Such factors include affordability, clinical need and clinical risk, and changes in external circumstances.

Across the 42 ICBs within the country, 40% do not routinely prescribe gluten-free bread and flour on the NHS, 14% have moved to restrict gluten-free bread and flour to select groups, and 43% continue to prescribe gluten-free bread and flour.

Within the midlands area, other areas including Derbyshire, Nottinghamshire and Leicestershire have stopped the provision of gluten free products.

Most major supermarkets and many other retailers now stock gluten-free foods, as well as other special diet alternatives, both online and in-store. In addition, improved food labelling now means people are better able to see whether ordinary food products are free from gluten. Further information on labelling can be found on the Gov.uk website.

Coeliac UK is working with partners to ensure those who access food banks have GF provisions:

Can food banks help people with coeliac disease on a gluten free diet? - Coeliac UK
https://www.coeliac.org.uk/food-businesses/news/helping-others/

Further information about Coeliac Disease and how to manage symptoms can be found by visiting - www.nhs.uk/conditions/coeliac-disease/www.nhs.uk/conditions/Coeliac-disease

There is a lot of information on the Coeliac UK website at www.coeliac.org.uk that you can access if you want advice about your diet including:

• Home of Gluten free recipes
• Diet and health workshops
• Food and drink information
• Gluten-free food on a budget

The Association of UK Dietitians also have a range of support and information - www.bda.uk.com/resource/coeliac-disease-and-Gluten-free-diet.html

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

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

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

• Household Support Fund – Support for cost of living - Lincolnshire County Council

Each district has a different application process, more information can be found here:

• Cost of Living Support – City of Lincoln Council
• Cost of living support | North Kesteven District Council
• Household Support Fund Grant | South Kesteven District Council
• Household Support Fund (HSF) - Boston Borough Council
• Household Support Fund - South Holland District Council
• Financial support | West Lindsey District Council
• Household Support Fund - East Lindsey District Council

It is complex to put together an average difference in cost between supermarkets and prescription costs, however, below are some examples of the variations (prices from NHS prescribing data and supermarket websites):

Costs at beginning of March 2025:

Genius gluten free white sandwich bread sliced:

Available on prescription cost - £4.43

From ASDA supermarket cost - £2.75

Glutafin gluten free 4 white rolls:

Available on prescription cost - £3.81

From ASDA supermarket cost - £1.75

Costs at beginning of March 2025

From Asda – Asda Free from White or Brown sliced Load (535g) = £1.90 (35.5p/100g)

From Asda – Warburtons GF white or seeded sliced loaf (300g) = £2.15 (71.7p/100g)

From Asda Sliced Wholemeal Tin Loaf 400g £1.15 (28.7p/100g)

From Asda- Asda GF plain/ SR flour £1.10/kg

Costs at beginning of March 2025

From Tesco - Warburtons white bread sliced (800g) = £1.40 (17.5p/100g)

From Tesco - Warburtons Gluten free white bread sliced (300g) = £2.15 (72p/100g)

Available on prescription - Warburtons Gluten free white bread sliced (400g) = £3.14 (78.5p /100g)

Costs at beginning of March 2025

From Tesco – Juvela gluten free soft white loaf sliced (400g) = £3.25 (81p/100g)

Available on prescription - Juvela gluten free soft white loaf sliced (400g) = £3.78 (94.5p/100g)

Available on prescription - Juvela gluten free fresh fibre loaf sliced (400g) = £3.76 (94p/100g)

Costs at beginning of March 2025

Available on prescription – Barkat gluten free all-purpose flour mix (500g) - £4.47 (89.5p/100g)

From Sainsbury’s – Freee Gluten Free Plain White flour (1KG) - £1.95 (19.5p/100g)

From ASDA - Free From Gluten Free Plain Flour (1KG) - £1.10 (11p/100g)

There are also hidden costs that the NHS must pay, which supermarkets don’t, such as costs associated with the time it takes a GP practice to generate a prescription and sign it.  Also, the cost of the pharmacy ordering the stock and processing the prescriptions and then the pharmacist checking it.  All these activities are funded either directly or indirectly by the NHS.

Prior to this consultation circa 800 people across Lincolnshire diagnosed with coeliac disease and dermatitis herpetiformis receive up to eight units of gluten-free bread or flour on prescription. These figures are shown below.

People can contact the NHS Lincolnshire ICB:

• Email: office@nhs.net
• Telephone: 01522 573939
• Write: NHS Lincolnshire Integrated Care Board (ICB), Bridge House, The Point, Lions Way, Sleaford, NG34 8GG