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Prescribing heroin set to be an 'opt in' GP service

The Government's new drug strategy will be allocated to the enhanced clinical services section of the new contract to overcome GP fears over prescribing diamorphine to heroin addicts.

The Home Office last week pressed ahead with plans to increase the number of heroin misusers prescribed diamorphine five-fold from 300 to 1,500 in the first stage of the strategy and said it would be putting pressure on GPs to help meet the targets.

GPC negotiators said the drug strategy would fall under enhanced services in the new contract, which GPs could opt in to with the assurance that they could control workload and have protected funds.

Enhanced services will be divided into national and local enhanced services. Unlike essential and additional services, not all practices will be expected to provide enhanced services. Instead, GPs can agree with their primary care organisation to provide them.

GPC negotiator Dr Peter Holden said: 'Drug misuse treatment would be a locally enhanced scheme at best. I don't believe treatment of addiction itself is a GP activity. We don't have the time.

'In my practice we've had to take on eight or nine of these people. They take up a grossly disproportionate amount of time and they are the only patients who have damaged the surgery.'

Some 133 GPs hold a licence to prescribe diamorphine, but a Home Office spokesman told Pulse the Government would put pressure on more GPs to apply for one. 'We would like to see an expansion of that where there is a clinical need. We believe there could be more of it,' he said.

Dr John Canning, chair of Middlesbrough LMC and a local GP, said he had funding and workload concerns over the strategy. 'Treatment requires a specialist service and it requires resources. Drug misusers require to be seen on many occasions in a year.'

Dr Rob Barnett, Liverpool LMC chair and GPC member, said GPs would ignore the strategy. 'I can't see very many of my colleagues wishing to get involved in prescribing heroin. You'll be able to count the numbers on one hand.

'We have enough problems recruiting GPs and maintaining the standard in general medical services, never mind the additional burden of looking after drug misusers.'

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