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GPs will face penalties for prescribing antipsychotics to patients with dementia

GPs will be expected to eradicate antipsychotic medication for patients with dementia or face potential financial penalties under stringent new commissioning indicators.

The target is one of 120 new draft indicators drawn up by NICE in the commissioning outcomes framework for clinical commissioning groups released for consultation last week.

A ‘proportion' of GP practices' income is expected to be linked to CCG performance against the framework under the planned quality premium.

The framework says: ‘The intent of indicator 1.23 is to measure the proportion of people with dementia who are prescribed antipsychotic medication. A threshold of close to zero is expected for this indicator.'

The recommendation adds to pressure on GPs over use of antipsychotics.

Health minister Paul Burstow has vowed to outlaw the ‘silent scandal' of inappropriate prescribing, and punish doctors if a target to reduce the number of elderly care home residents and dementia patients prescribed antipsychotics from 180,000 to 60,000 is not met.

The plans could see GPs who prescribe the drugs without permission facing up to five years in jail under the Mental Capacity Act.

But writing in Pulse last month, Glasgow GP Dr Margaret McCartney said: ‘Witnessing carers trying to keep a loved one at home despite physically aggressive behaviour is heartbreaking – and the stigma of using small doses of medication unnecessary.'

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