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Practices face cash penalty for altering script intervals

GPs who shorten prescribing intervals at the end of the financial year to meet their drug budgets risk having development cash withheld, the GPC has warned.

In a recent statement to GPs, the GPC said it was aware of such practice and warned PCTs could identify practices taking such measures using electronic prescribing analysis and costing (ePACT) data.

Dr Peter Fellows, chair of the GPC prescribing sub-committee, said GPs opting to 'play the system' to come within budgets at the possible expense of 'quality' prescribing could be 'leaned on behind the scenes'.

He suggested the withholding of development cash as one possible measure PCTs might adopt instead of disciplinary action. He added: 'Costs need to be centralised, it is unfair of the Government to make PCTs pick up prescribing costs.'

Dr Andrew Rigby, a GP in Tewkesbury, Gloucestershire, and treasurer for Gloucestershire LMC, said there was a

real possibility of PCTs using fiscal measures to discipline GPs taking such prescribing measures.

'It is much more likely than disciplinary action through the GMC,' he said.

Dr Jim Kennedy, RCGP prescribing spokesman and a GP in Hayes, Middlesex, defended GPs, saying he doubted PCTs would need to resort to disciplinary action. 'There are better ways for GPs to spend their time than trying to change prescribing at year-end.

'Money can be made in other ways that are in patients' best interests.'

Sue Mulvenna, head of medicines management for South Gloucestershire PCT, said it would be hard to prove anything from ePACT data. 'We're moving away from wielding the stick ­ all our prescribing incentives are quality based,' she said. 'Development cash is on-hold because of local debts ­ GPs may feel under pressure on budgets.'

Dr Paul Colbrook, medico-legal adviser for the Medical Defence Union, said the GMC's guidance was clear. 'If resources are limiting good patient care then GPs must try to rectify the situation or else bring it to the attention of the PCT.'

The GPC has advised it is more appropriate to prescribe drugs such as combined oral contraceptive pills, antihypertensives or medication for stable conditions, on longer prescriptions on a three- to six-month basis.

By Rob Finch

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