The UK Gluten Free Prescription Divide Why Support for Coeliac Disease Depends on Where You Live

If you live with coeliac disease in the UK you already know that eating gluten free is not a choice, it is your medical treatment. Yet depending on your postcode the amount of support you receive can look completely different.

Some people can still access a wide range of gluten free foods on prescription. Others are being told they cannot even get bread anymore. And most people do not realise how uneven the system has become until they experience it directly.

This blog breaks down the rules in each part of the UK and explains why the current system feels so unfair.

England

What people can actually get

In England only three staple items are officially allowed on prescription

• gluten free bread

• gluten free rolls

• gluten free flour mixes

That is the national policy. However even these staples are not guaranteed. Local Integrated Care Boards can reduce or remove prescribing completely which many areas have already done.

This means that depending on where you live you may still get some items or you may be told you must purchase everything yourself.

Prescription charges also still apply unless you are exempt.

What has been removed

Everything else has been cut including

• pasta

• cereals

• crackers

• biscuits

• pizza bases

• cakes and mixes

For a lot of families especially those managing the cost of living this makes a huge difference.

Scotland

A completely different experience

Scotland offers significantly better support. People diagnosed with coeliac disease can receive a wider range of gluten free staples including bread pasta cereals and crackers.

Prescriptions in Scotland are free at the point of collection which removes an extra financial barrier.

Scotland also has a more consistent national approach which means people receive similar support no matter where in the country they live.

Wales

Strong support plus something new

Wales currently provides support similar to Scotland with bread mixes, pasta and other staples available through prescription.

Wales is also rolling out a brand new subsidy card scheme.

This card will allow people with coeliac disease to buy gluten free essentials directly in shops with financial support from the health service.

This is the first scheme of its kind in the UK and could shape the future of gluten free access elsewhere.

Northern Ireland

Broad support still in place

People in Northern Ireland can also access a wider range of gluten free staples on prescription including bread cereals and pasta.

Like Scotland and Wales these prescriptions are free at the point of collection which helps remove some of the financial strain.

Why all of this matters

For people with coeliac disease the gluten free diet is not optional. It is the only medically accepted treatment and strict lifelong adherence is essential.

Yet in 2026 support varies dramatically across the country. Someone in Scotland or Wales can access pasta crackers and cereals through their health service. Meanwhile a person in England may be refused even basic bread and flour mix depending on their local area.

The result is a postcode lottery. Your access to medically required food depends on where your home happens to be.

When you combine this with the significantly higher cost of gluten free food in supermarkets the system becomes even harder to navigate for individuals and families trying to manage symptoms and stay healthy.

What needs to change

The inconsistency between nations raises important questions:

• Should medical treatment vary based on geography

• Should England reconsider providing broader support

• Should all nations adopt a flexible system like the new Welsh subsidy card

Until there is a UK wide approach people with coeliac disease will continue to face unequal access to essentials that directly affect their health.