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Fair-shares prescribing budget to scupper PBC

By Helen Crump

PCTs are slashing prescribing budgets and moving to a 'fair shares' allocation of the money in a move which is set to scupper GPs' practice-based commissioning plans.

Four trusts in Somerset have cut £4.5 million from this year's prescribing budgets and removed all adjustments between practices for historical spend.

The move by Mendip, Somerset Coast, South Somerset and Taunton Deane PCTs has axed 12 per cent from some practices' budgets, making it almost inevitable they will overspend.

GPs in the region said the cuts made it impossible to make savings under PBC. Other GPs predicted other PCTs would follow suit because of the need to bring down deficits.

Dr Harry Yoxall, Somerset LMC secretary, said GPs were mystified as to why the PCTs, none of which is in deficit, had made the decision.

He said: 'It's going to be difficult to make any PBC plans if you've got a significant prescribing deficit. Practices are going to struggle to meet the budget. It will be very easy to say ''forget it, why bother?''.'

Government guidance on PBC states that prescribing budgets should be 'attributed using current formulae' and allocated to practices accordingly in their indicative budget.

A move to fair-shares PBC budgets nationally is not planned until next year at the earliest.

Dr Rupert Sells, a GP in Taunton, faces an 11.4 per cent cut at his practice. His patient list includes a nursing home with 10 patients on peg feeds and an above-average number of patients with schizophrenia.

He said: 'We're traditionally high prescribers, but for good reason. I suspect the reason for the drop is that these costs are no longer factored in. It makes it difficult to see how we could possibly reach our target – you can't deny patients the treatment.'

Dr Peter Fellows, GPC prescribing subcommittee chair, said he thought the trusts' move was designed to allow them to blame GPs when prescribing budgets were exceeded.

Dr James Kingsland, chair of the National Association of Primary Care, said the cuts would 'store up problems'. 'Too many PCTs are trying to meet financial targets by top-slicing and rationing, which never did anything to engage clinicians.'

A spokesman for the PCTs said GPs were being asked to replicate savings made by 'many practices' last year.

He added that the change would have 'no effect on patient care'.

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