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Independents' Day

GPs to take control of prescribing budgets and keep half of any savings

A dozen practices in Yorkshire are taking control of their own prescribing budgets in a bid to help cut the CCG’s £44.1m deficit, and will be allowed to keep half of the money saved.

NHS Vale of York CCG has given the practices control of their prescribing finances in what it describes as ‘a radical shift to help prioritise resources’ - although the budget will still be owned by the CCG.

It aims to improve prescribing and cut waste as part of its drive to cut ‘waste and inefficiency’.

Under the scheme, practices will be required to plough any savings back into services, and there will be no set targets.

The CCG has a £50 million medicine bill annually, including £1 million spent on wasted medicines every year – the equivalent of 22,222 GP appointments – while more than half of the money is spent on supplying paracetamol to patients.

In the past, the prescribing budget covered all the practices in the Vale of York, without a break down for individual practices, according to the CCG.

The participating practices are Clifton, Elvington, Front Street, Helmsley, Millfield, Old School, Petergate, Pickering, Stillington, Terrington, Tollerton and the York Medical Group.

If the scheme is a success it hopes to extend it to the other 14 practices in the CCG.

The CCG’s joint medical director and clinical lead for prescribing Dr Shaun O’Connell said: ‘Prescribing Indicative Budgets have been introduced to groups of practices to help them to identify areas where the standards of prescribing can be improved and a result identify any potentially wasteful or cost-inefficient prescribing.

‘In essence groups of GP practices have been given the prescribing budget, in an indicative form, to actively manage and it is estimated that this will identify considerable savings which can be diverted to priority areas of health need.’

GP Dr Andrew Field, who is chair of City and Vale GP Alliance Board said: ‘We are excited about the opportunity to have an increased responsibility of our prescribing budgets in order to ensure our patients are receiving the most appropriate medication for their needs.’

He said patients will still get the medication they need.

The CCG is already running a campaign to encourage patients to think carefully about requesting drugs, such as paracetamol and antihistamine, which are available cheaply over the counter.

NHS Oxfordshire CCG launched a similar scheme in May which aimed to save £1.45 million initially.

It was opposed by Berkshire Buckinghamshire, and Oxfordshire LMCs (BBOLMC), which issued a ‘red RAG’ rating to highlight problems with the scheme.

The CCG said it had a high take-up, with most practices signing up to the scheme, which is designed to save £2 per patient.

So far this year medicines optimisation has saved £443,000, the CCG said.

Readers' comments (13)

  • I spent 15 minutes last week trying to convince a patient that generic co-codamol was exactly the same as his beloved trade version. It will probably save us about 3 quid a month. Still, I felt like I had achieved something, had helped the budget in some small way and helped with patient education. The same day I was told to prescribe liquid mebeverine for a patient by one of the local paediatricians. It’s going to cost us £8000 per year. 8 grand! Ever feel like our job title should be changed to Titanic Deck Chair Technician?

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  • did you contact that stupid paediatrician?

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  • i can see no end of complaints and difficult consultations resulting from this initiative. patients will always say -- you're trying to put me on cheaper drug because YOU are going to gain from it.
    What are we supposed to say then?

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  • These prescribing incentives are ethically distasteful to say the least. If the Nation cannot afford it's drug bill then taxes will have to rise.

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  • Pts will certainly not get 'the most appropriate medication for their needs', they will get the most appropriate, read cheapest, medication available to meet the budgetary needs.

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  • It's perverse. Practices with historically profligate prescribing can earn money by curbing their excesses. Others who have already worked hard to cut to the bone can save nothing more. Such schemes reward the wrong people

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  • Vinci Ho

    On another angle , it begs serious question why and how drug companies justified the expensive price tags on certain medications, particularly those widely used . Mebeverine liquid is one and we all learnt the story of phenytoin last year . Tale of Pregabalin/Lyrica has become a black comedy as the drug is approaching controlled status.
    All in all , government(s) were helpless in stamping pressure on these big companies to stop exploitation. Do not want sound too left wing but clearly there are no checks and balances .
    Every tree has its bad apples but the phenomenon we had witnessed through recent history, suggested there were clearly flaws in how new drugs were passed and licensed for widespread usages. Remember the stories of Rofecoxib, Rosiglitazone and perhaps Sibutramine?
    Personally, always sceptical about studies supporting null hypothesis with p-values as low as

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  • Vinci Ho


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  • Vinci Ho

    less than 0.0001 , for instance

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  • This is quite simply a conflict of interest that will come back to haunt any doctor involved. Don't do it.

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