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GPs face funding squeeze on drug budgets

By Nigel Praities

Exclusive: GP drug budgets will bear the brunt of stringent PCT cost controls for the next two years amid evidence of growing disquiet over the rationing decisions taken by trusts.

PCTs in England are on average freezing their GP prescribing budgets for the current financial year and uplifting them by only 3% for next year, data from 76 trusts reveals.

The budget squeezes come despite rising primary care prescribing – with an increase of 5.8% in prescriptions issued last year – and double-digit percentage rises in funding planned for areas such as smoking cessation and sexual health.

And the average figures mask cuts in GP prescribing budgets in some areas of the country, with a third of trusts reducing their budgets this financial year, by an average of £1.6m each, and others planning reductions the year after.

Figures released to Pulse under the Freedom of Information Act also reveal the squeeze is bringing rising numbers of requests for so-called ‘exceptional funding', for treatments PCTs do not routinely provide.

Trusts received an average of 212 requests in 2006/7, but this doubled to 420 last year. The proportion accepted remained about the same.

A Pulse survey of 200 GPs found widespread concern over rationing of treatments by PCTs, with 51% saying it adversely affected their care of their patients.

Although more than four GPs in five acknowledged rationing of treatments was necessary in the NHS, only 31% had confidence in their local primary care organisation to ration treatments, while 48% had confidence in NICE or SIGN.

PCTs say savings will come through more efficient prescribing. NHS Sefton is cutting its GP prescribing budget by £1.1m this year and next year and a spokesperson said the cuts would come from GPs prescribing cheaper medicines: ‘The PCT will be making savings by supporting GP practices to achieve an increase in generic prescribing, particularly in practices with a low rate of generic use.'

Dr Prakash Chandra, a GP in Manor Park, east London, and chair of Newham LMC, said the cuts in his area would backfire.

‘This will have a significant impact. Generic prescribing in Newham is around 84% – quite high. But the PCT is pushing for more. It's bad news, they want more care to be in the community, but these cuts mean patients will end up in secondary care.'

GPs face cuts to their prescribing budgets

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