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Independents' Day

GPs cut NHS prescribing bill by billions but 'can do more', says think-tank

GPs have saved the NHS around £7bn in the last 40 years by increasing generic prescribing but can still do more, an influential health think-tank has suggested.

The King’s Fund’s Better value in the NHS report said that although generic prescribing rates have gone up by 20% since 1976, GPs should be able to further reduce costs by millions of pounds each year by reducing overdiagnosing and inappropriate prescribing.

As an example, the report pointed specifically to NICE estimates that £3.7m worth of savings may be found from cutting or reducing antibiotic prescriptions for a number of respiratory tract infections, such as coughs, colds and sore throats. It also pointed to a research study that found COPD treatment with inhaled corticosteroids - drugs to reduce inflammation - were likely overprescribed in general practice.

The King’s Fund further suggested GPs could save money by better idenification and management of mental health issues at an early stage, particularly among the large group of patients whose needs were below the level requiring specialist referral.

The think-tank said that taking these measures to reduce cost of clinical practice were particularly important in light of NHS England’s goal of saving a further £22bn off the NHS budget over the next five years.

The report said: ‘Although the Conservative Government has made a welcome commitment to increase funding by at least £8bn in real terms by 2020/21, this will not be sufficient to meet the needs of a growing and ageing population and to pay for advances in treatment. It is therefore all the more important that the NHS redoubles its efforts to deliver better value in the ways we describe.’

The recommendations come as the Government has opened up for a widening of the prescribing remit in general practice to also include physician associates. Meanwhile it will also spend £15m on employing pharmacists to work in GP practices.

Earlier this month, statistics released by the Health and Social Care information Centre showed that the number of items prescribed on the NHS has increased by 55% since 2004, with 1.1bn items dispensed into the community in 2014.

Readers' comments (20)

  • **** *** !
    The way to save money is to scrap all these crappy "think tanks" staffed by people who have no practical knowledge of anything....their opinions are unwelcome and offensive.

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  • Low antibiotics, high septicaemia.

    Low septicaemia, high antibiotics.

    Please tell us which you'd like.

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  • How much can hospital doctors save? Why is it always "GPs to do"? We are paid less and less each year and expected to do more and more mainly, presumably, because we are paid per patient and all our extra work is unfunded (at a cost only to us and our families). As more care is devolved to/dumped on primary care, GPs' prescribing will go up.

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  • I already prescribe a low rate. Fine. Provide us with POC testing for CRP and Strep, and I will do it.

    As I work in a third world country (the UK) until you do, please go away and sit on your backsides and dream up something else for us to do.

    Oh, and let the NHS indemnify me against the Daily Wail destroying my life if I miss meningitis 12 hours after seeing a child? You wont? Bye bye then.

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  • Look at my face am I boverd,we never see any of the savings in an underfunded GP land our saving fill in secondary care holes.As for our hospital bretheren welcome to another 5 years of pay cuts.In GP land it will be a bigger cuts as we move toward a living wage for minimum wage staff.Now what will I cut first staff numbers/my own pay or services.Work seven days a week no chance mate.

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  • The GP's "Better Value in the NHS" report said that although generic verbiage rates have gone up by 2000% since 1976, pompous think tanks should be able to further reduce costs by millions of pounds each year by reducing ivory-tower interference and inappropriate meddling.

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  • Pfft. Stop straining at gnats. I'm not saying it's right, I'm not saying it's wrong, but I suspect that the cost of keeping one very premature baby or one critically injured RTA casualty alive for 24 hours costs more than my annual expenditure on antibiotics, inhaled corticosteroids and mental health medications combined.

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  • I was particularly annoyed by the mental health comment.

    I think mental health patients get a shockingly bad service. I am quite happy to say my prescribing for mental health patients is not as good as a psychiatrist's might be.

    The answer is not to have a:
    "large group of patients whose needs were below the level requiring specialist referral"

    but intact make mental health services better so that they are all managed by experts.

    What is wrong with a cohort of people with a serious illness accessing specialist support so that they get the best treatment.

    It is the one area of medicine which would have a huge impact if patients could directly access specialist care. Make that happen rather than blaming GPs for giving a standard of care that is not as good as a specialist.

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  • Sorry I am mostly trying to avoid missing results and 'gp to chase possible cancer cxr' letters whilst trying to cope with ridiculous increasing demand. Shaving more money off prescribing - not my problem.

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  • Less than 8% of funding goes to GP land,where as the rest goes to the rest of the NHS.1% of savings in secondary care could add an equivalent for an extra 10% + to the funding of primary care think tanks seem to sprout meaningless S**t. Primary care is already running pretty lean we are become spent with the scavengers ready to pick our carcass clean,all they are doing is hastening the demise of the "Jewel in the crown" as some privateer said.

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