27 March 2018




AMSTERDAM, The Netherlands, Tuesday 27 March 2018, 00:02 AM CET/ 00:01 AM BST. Norgine is extremely concerned about the inclusion of constipation as a “minor” illness in new NHS England proposals to cut GP prescribing for certain health conditions.


The inclusion of constipation, alongside other conditions such as dandruff, trivialises what can be a very serious condition. The consultation classifies constipation as “infrequent” or “minor”. However, these are not medically recognised classifications and we consider that this lack of clarity will only serve to increase the variation that this consultation seeks to address. All chronic and serious constipation begins with what would be here described as “infrequent” or “minor”. Similarly, “infrequent” constipation may also be very serious.


June Rogers MBE Specialist Continence Adviser, Bladder and Bowel UK said: “We need to be mindful of the fact that constipation is not a ‘minor condition’ and that it may be a symptom of an underlying co-morbidity. The concern is that individuals may try to self-manage the problem by buying over the counter treatment, without seeing a health care professional and undergoing an appropriate assessment. The elderly are particularly at risk and the following document highlights the issues for those individuals with learning difficulties https://www.ndti.org.uk/uploads/files/Constipation_RA_report_final.pdf.[ii]


Dr Penny Dobson MBE, Chair, Paediatric Continence Forum added: “The Paediatric Continence Forum (PCF) has significant concerns that NHS England’s proposals to restrict the prescription of laxatives for infrequent constipation could result in children with constipation not receiving appropriate treatment, and the very real and concerning risk of this condition deteriorating into the serious condition of impaction. Constipation and other bladder and bowel issues which begin in childhood can persist into adulthood, particularly if appropriate treatment is not sought or offered, and can result in reductions in school attendance, visits to A&E and emergency admissions for faecal impaction. Restricting the prescription of laxatives because they can be bought over the counter could also result in parents not understanding the importance of treating their child’s constipation, or force parents with limited financial resources to make difficult decisions about their child’s health. We would urge NHS England to reconsider these proposals and consider the clinical benefits and the substantial savings that can be gained from delivering appropriate care for bladder and bowel issues at the earliest possible stage.”


Anton Emmanuel, Consultant Neuro Gastroenterologist at University College Hospital and the National Hospital for Neurology and Neurosurgery said:

“Although constipation is a very common condition, it is a very serious one. For those suffering, it can result in serious quality impairments in quality of life and, if inappropriately treated, is associated with significant costs in the form of unplanned admissions to emergency departments. Even in constipation that might be considered “minor” or “infrequent”, there are a wide range of symptoms and every patient is different. Encouraging self-help medication requires caution. Serious health issues often start with minor symptoms. It is essential that patients are encouraged to visit their GPs to discuss their symptoms and to receive the most appropriate advice and treatment.”


He added: “I am very worried that these proposals will actively discourage patients from speaking to their GPs about what is already considered a taboo subject, which will lead to many more cases of severe illness and trips to A&E.”


Peter Martin, COO at Norgine said: “While we acknowledge that the revised proposals allow certain patient exemptions – the guidance is vague and requires patients to prove to their GP that ‘exceptional’ circumstances warrant them receiving free NHS treatment. We believe this is unworkable and unfair.”


He added: “We strongly believe that NHS prescribing, for whatever medical condition, should be made based on clinical need – and not the ability to pay. Including constipation in these proposals is the thin end of the wedge – exacerbating health inequalities, reducing patient outcomes, and eroding basic NHS principles”.


Constipation – key facts:


  • Constipation can be associated with a series of physical and learning disabilities – as well long-term and chronic illnesses such as Parkinson’s disease, colorectal cancer and diabetes– which require medical investigation 
  • It particularly affects the most vulnerable in society including the young, elderly, and pregnant and post-natal women
  • Currently, one in three over the age of 65 – and one – third of children under the age of nine in the UK are affected
  • Chronic constipation is causing people to suffer in silence and pain, leading to

66,287 hospital admissions in 2014/15[iii] at a cost of £145 million to the NHS[iv]

  • Left untreated – particularly in infants – the condition can deteriorate quickly and lead to fatal complications such as faecal impaction, ulceration of the colon, gastric bleeding and perforation.


GL/COR/0318/0138, 22 march 2018


Notes to Editors:

About Norgine


Norgine is a leading European specialist pharmaceutical company with a direct commercial presence in all major European markets. In 2017, Norgine’s total net sales were EUR 345 million, up 17 per cent.

Norgine employs over 1,000 people across its commercial, development and manufacturing operations and manages all aspects of product development, production, marketing, sale and supply.

Norgine specialises in gastroenterology, hepatology, cancer and supportive care.


Norgine is headquartered in the Netherlands. Norgine owns a R&D site in Hengoed, Wales and two manufacturing sites in Hengoed, Wales and Dreux, France.


For more information, please visit www.norgine.com and www.norgine.co.uk

In 2012, Norgine established a complementary business Norgine Ventures, supporting innovative healthcare companies through the provision of debt-like financing in Europe and the US. For more information, please visit www.norgineventures.com.

NORGINE and the sail logo are trademarks of the Norgine group of companies.


Media Contact:

Isabelle Jouin, T: +44 (0)1895 826237

Lynsey Conway T: +44 (0)7778 304233

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[i] UK consultation: Conditions for which over the counter items should not routinely be prescribed in primary care: a consultation on guidance for CCGs

[ii] https://www.ndti.org.uk/uploads/files/Constipation_RA_report_final.pdf

[iii] HSCIC, Hospital Episode Statistics, 2014-2015, Primary Diagnosis 4 Character http://www.


[iv] Calculated using above admissions data and hospital treatment costs from Department of

Health, 2014, Reference costs 2013-14, p. 5, ‘Finished Consultant Episodes’: https://www.

gov.uk/government/uploads/system/uploads/at tachment_data/file/380322/01_Final_2013-14_Reference_Costs_publication_v2.pdf