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Over the Counter (Self-Care)

Over the counter (OTC) medicines – Prescribing Commissioning Policy and Letter for nurseries and schools

In November 2016, NHS Wirral Clinical Commissioning Group, implemented a self-care policy for minor health problems, which says that patients should access advice and purchase such homely remedies as they and their family need rather than being prescribed by their GP or other clinicians. This policy was updated last August 2018 following national guidance, available at:  The policy has been updated again recently in February 2020 to strengthen the key messages including:

NHS Wirral CCG will not fund the prescribing of medicines and treatments for minor, short-term conditions where;
                 o Self-care is the most appropriate route
                 o Medicines and treatments are available to buy over the counter

The current CCG policy can be found at;

To support the continued implementation of this policy, NHS Wirral CCG would like to clarify the interpretation of the current guidance around use of medicines in nurseries and schools. Click here to see the letter which has been circulated to all Wirral nurseries and schools.


Hay fever

Hay fever is a common condition that affects up to one in five people in the UK.  There is currently no cure for hay fever, but most people with mild to moderate symptoms are able to relieve symptoms with over the counter (OTC) treatments recommended by a pharmacist.

As per the NHS Wirral CCG Self-Care Policy, which is available at:, a prescription for treatment of mild to moderate hay fever will not routinely be offered by your GP as the condition is appropriate for self-care.

What is Hay fever

Hay fever is an allergic condition where the body’s immune system overreacts to a substance that is usually harmless. With hay fever the substance is a fine powder called pollen. There are several types of pollen, for example, from grasses, weeds or trees and they are produced at different times of the year.

Tree pollen: between February and June
Grass pollen: between May and July
Weed pollen: between June and September

The pollen causes the release of a chemical called histamine from cells in the nose, eyes and airways.  This causes inflammation in the nose and eyes, and sometimes the sinuses and throat can also be affected. It often runs in families and is more likely to affect people who suffer from asthma and eczema. 

Symptoms include:

  • sneezing and coughing
  • a runny or blocked nose
  • itchy, red or watery eyes
  • itchy throat, mouth, nose and ears
  • headache
  • loss of smell
  • sinus pain
  • earache
  • feeling tired


Managing the condition

The severity of symptoms can vary, some people need medication to manage their symptoms and others can manage their condition by avoiding triggers. If treatment is needed a wide range of medications can be purchased from community pharmacies and supermarkets without seeing a doctor. These medicines are often cheaper than medicines on prescription.

Tips for avoidance

  • Keep house and car windows closed, especially when the pollen count is high, in the morning and evening.
  • Avoid large grassy areas, woodland, cutting the grass, pollutants and car fumes.
  • Wear wrap-around sunglasses.
  • Shower and change when you come indoors to wash pollen off.
  • If possible, stay indoors when the pollen count is high.
  • Use petroleum jelly inside your nose to block inhalation of pollen.
  • vacuum regularly and dust with a damp cloth
  • Do not dry washing outside to avoid pollen sticking to your clothes.
  • Use a pollen filter for the air vents in the car.

Speak to the pharmacist:

OTC medicines can help to relieve symptoms and community pharmacists will be able to offer advice on the most suitable treatment:

  • Oral antihistamines
  • Nasal preparations (antihistamine/steroid nasal sprays)
  • Oral decongestants
  • Eye preparations
  • Simple pain relief

See the GP if the patient:

  • Is pregnant or breastfeeding.
  • Has symptoms which are getting worse.
  • Has symptoms that do not improve after taking medicines from the pharmacy in combination with measures to reduce exposure to pollen.

Pollen Count

More information on hay fever is available at: