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Independents' Day

MPs demand end to 'perverse' cost to GPs of testing before antibiotic prescribing

Leading MPs have called for changes to the 'perverse' financial arrangements that stop GPs from using point-of-care testing before prescribing antibiotics.

The House of Commons Health and Social Care Committee report on antimicrobial resistance, published today, said that ‘encouraging the development of rapid diagnostic testing’ should be looked at as a way of reducing prescribing, but only where it is clinically appropriate and recommended by NICE.

But it added that GPs are being discouraged from using point-of-care testing because they are expected to pick up the bill rather than the CCG.

The report said: 'Rapid diagnostic tests are already recommended by NICE for certain infections, but we heard that often these are not used because the cost of the test—which is far higher than the cost of antibiotics—falls on individual GP practices rather than the CCG...

'Where testing is clinically appropriate and recommended by NICE, action should be taken to address the perverse financial incentives which may discourage their use.'

In evidence given to the committee, University of Southampton Professor of primary health care research Michael Moore said: ‘What happens is that the costs of those tests are met in primary care, and the antibiotics are paid for at the CCG level.’

He explained that if GPs carry out 100 c-reactive protein (CRP) tests, 'you are asking them to spend £1,000 on that testing'.

‘That is an implementation problem. It is about getting the resource in the right place to get these things implemented,’ Professor Moore added.

The report concluded that encouraging the development of rapid diagnostic testing should be considered alongside the action to promote the development of new antimicrobials, but use of diagnostic tests should be based on NICE guidance’.

This comes after NHS England revealed plans for c-reactive protein diagnostic testing in primary care, as part of its new UK Antimicrobial Diagnostic Collaborative programme.

Some GP practices have already started to implement CRP testing, although the cost has proved a barrier in cases where the CCG refused to fund it.

Readers' comments (6)

  • This has to be backed up by funding,not only the test,but the extra time needed to implement that test.But as always our time is limitless free and we are best place etc etc. That will never happen and the codes will continue.

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  • Code read exodus!predictive text!!!

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  • Well our CCG scored it for investment - didn't meet the criteria for doesnt have the predidictive value that say d dimer haas in TED. We also thought it may increase consultation rates as people more likely attend just in case

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  • Hmmm? is this a first for the NHS- a group of MP's that actually showed some commonsense???!!!.so POCT has a cost in time and money?? who would have thought? next bright idea-educate pt's to ask for the test rather than the treatment??How much will that cost? then do a cost benefit analysis that suggests that doing the right thing is too expensive- so pass the buck back to the GP !!

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  • How does CRP differentiate between bacterial inflammatory disease and viral inflammatory disease
    Strep B testing is available but again there are costs
    The council of perfection with no cost to any one is from LaLa land

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  • When someone dies from meningitis from a sore throat, these pen pushers will not hesitate to promote complaints, criticise you:"It's your clinical decision" and charge you with "gross negligence manslaughter" for not doing a CRP or prescribing an antibiotic. The UK environment is really toxic.

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