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Gold, incentives and meh

PCTs widen switching drive

GPs are facing a swathe of fresh prescribing controls after NHS managers agreed targets for low-cost versions of a series of drugs on top of statins.

Strategic health authorities have been discussing new prescribing controls since the turn of the year and NHS West Midlands has become the first to take action, introducing a series of indicators covering proton pump inhibitors, antihypertensives and antiplatelets, as well as a toughened target for use of generic statins (see above).The NHS Institute for Innovation and Improvement, which drew up the Better Care, Better Value indicator for statins, is understood to be drawing up national guidance after consultation with other bodies including North West SHA.Individual PCTs are also implementing schemes to extend drug switching beyond statins.Dr Chaand Nagpaul, a GP in Stanmore, Middlesex, said Harrow PCT was implementing a series of new indicators.Dr Nagpaul, a member of the GPC prescribing sub-committee, said many PCTs had implemented changes so fast there had not been enough time to investigate patients individually.'With statins, switches have occurred just on repeat prescription forms and with a letter telling patients,' he said.But Dr Lorna Gold, a GP in Solihull, West Midlands, insisted her local drug switching scheme had been done safely, with a PCT pharmacist visiting the practice every week to go through patient records.'She's very good about checking if there is any reason why individual patients shouldn't be switched,' said Dr Gold.

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