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Let's implement the NSFs in full

A simple action that would be to patients' benefit is to target the holy grail of generic prescribing percentages ­ by implementing all the national service frameworks and new contract targets.

Just prescribe the most expensive appropriate product by brand name, remembering especially where there are cheap generics available and avoiding them.

We shouldn't accept any cholesterol that the laboratory can detect as reasonable. Everyone who has any vague family history needs lifelong statins and a few other drugs may be appropriate as well.

We could equally implement the cancer referrals requirements with excessive zeal but would have to identify a mechanism with consultant colleagues that would wreck statistics without blocking access to those who actually need it ­ this might be seen as being nearly as statistically honest and upright as the Government.

Dr Brian Mansfield

Beckington

Somerset

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