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‘Nearly all’ practices sign up to red-rated cash-incentive prescribing scheme

'Nearly all' practices have signed up to a regional scheme to cut costs on drug prescriptions, despite local GP leaders advising against it, according to the CCG in charge.

The Oxfordshire prescribing incentive scheme, revealed in May, is designed to save £2 per patient, with £1 of that being returned to GP practices. It involves reviewing prescriptions to care home residents in order to ‘optimise medication’.

The scheme was rejected by the Berkshire, Buckinghamshire and Oxfordshire LMCs (BBOLMC), which initially advised practices not to sign up.

The scheme is aimed to deliver initial target savings of £1.45m for the CCG, with a possibility for additional savings through agreement of individual practice plans, the CCG had said.

But, at the time, the BMA's GP Committee criticised the CCG for taking a cost-saving approach to its medicines optimisation scheme.

Despite this, and the LMC opposition, the scheme has gone ahead and received high uptake, according to NHS Oxfordshire CCG.

A spokesperson said: ‘The approved prescribing incentive scheme is currently being rolled out in Oxfordshire. Nearly all GP practices in Oxfordshire have signed up to the scheme with talks ongoing with the remainder.

‘Among several initiatives, GPs will look at the drugs their patients are being prescribed to make sure they are getting what they need and in the right amounts to help reduce waste.

'The CCG is working with its GP practices to ensure they have appropriate plans in place for their patients.’

BBOLMC chief executive Dr Paul Roblin told Pulse that the scheme has not been modified, despite facing harsh criticism, and the LMC have retained their red RAG rating to alert practices to problems with the scheme.

He said: ‘We hope that practices look in greater detail and make up their own minds. If they decide to go ahead, that’s up to them, but they have at least had an alert.'

He added: ‘There are lots of things being asked of GPs at the moment with trivial funding that really doesn’t cover the cost. We feel GPs are being taken for granted as a relatively cheap resource.’

Reducing the CCG prescribing bill

The news comes as the Government is currently working on national schemes to reduce the NHS prescribing bill.

It has tasked NHS England with reviewing which 'low-value' prescription items and over-the-counter medicines GPs could be asked not to prescribe to patients.

However, the GPC has said the plans would be 'unworkable' and 'unacceptable' for GPs, and would require the DH to actively 'blacklist' certain items from ever being prescribed on the NHS.

It also comes as a recent report showed that half of CCGs are planning to delay or cancel spending this year to meet financial targets.

However, in light of media scrutiny, NHS England has asked regions seeking to ration access to elective care services by introducing new thresholds or ‘lifestyle’ criteria to seek pre-approval ‘at least four weeks’ in advance.

Readers' comments (7)

  • Worked extremely well in Suffolk and most GPs think that the changes made to achieve the savings were not savage and did not affect patient care.

    Instead it rewards GP surgeries for doing to boring work of checking that drug prescriptions are optimised.

    Why shouldn't GP surgeries be rewarded for the effort of changing everyone from venlafaxine to vensir? Or the effort it takes to tell someone to buy their own cetirizine? It takes a lot of time and is not core work.

    Similarly it means dispensing practices are not shooting themselves in the foot by helping the CCG become more efficient.

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  • mostly stuff you might do anyway so might as well get paid for it.

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  • Lmc is useless. Bunch of ccg and NHSE agents. Living on our money and doing nothing for gps.

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  • Healthy Cynic

    "But, at the time, the BMA's GP Committee criticised the CCG for taking a cost-saving approach to its medicines optimisation scheme."
    God forbid that we might take a cost-cutting approach to healthcare! Isn't that what every government reform and initiative in the last 20 years has been???

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  • We don't sign up for the penny- simple reason - they pay you half of what they should and you are supposed to be grateful. There is no transparency - there is gross corruption which is unabated, unleashed at local levels and NHSE is running amok with NHS Digital as a front to keep it out of the picture. Try getting any information from NHSE about your payments and you will understand what I mean.

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  • You make the savings and NHSE and CCGs pocket it; good work - feed parasites:)

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  • Nothing controversial, the case for de-prescribing is well made. Its in NICE guidance, frailty guidance and the massive multimorbidity evidence base. Cost effective prescribing or cost effecting medicine in general is part and parcel of GP training. The LMCs are a bunch of useless backward obstructive GPs who are behaving like an out of touch trade union. The work will be done for good medical reasons, if it achieves increased funding for practices then that's great. If it doesn't there isn't any penalties... Not sure what's the issue here. Pulse you're not being objective

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