To ask the Secretary of State for Health whether NHS organisations are not permitted under the Health Act 2009 to publish guidance or make any form of direction which advises or encourages clinicians to prescribe only warfarin as the first-line option for drug treatment in patients who meet the clinical criteria set out in National Institute for Health and Care Excellence guidance (a) TA249, (b) TA256 and (c) TA275.

There is no statutory prohibition on national health service organisations providing prescribing guidance to clinicians.

Clinicians can prescribe any product which they consider necessary for the treatment of their patient under the NHS. This is subject to two provisos in primary care: firstly, that the product is not included in Schedules 1 or 2 to the NHS (General Medical Services contract) Regulations 2004 and secondly, that the clinician is prepared to justify any challenges to their prescribing by the relevant NHS commissioner. The availability of specific prescribed treatments in NHS secondary care may be subject to the agreement of the relevant commissioner to fund them, but NHS commissioners are required to fund drugs and treatments recommended in National Institute for Health and Care Excellence technology appraisal guidance where a clinician believes they are appropriate.