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Prescribing overspends threaten GP earnings

GPs are being warned to expect funding cuts in IT, acute care and enhanced service investment as primary care organisations grapple with prescribing overspends resulting from the quality and outcomes framework.

PCOs say spiralling spending on statins, antihypertensives and drugs for diabetes, asthma and COPD will force them to look elsewhere for cuts.

The RCGP says PCOs face a 'strategic nightmare' trying to balance drug budgets after the quality framework is thrown into the mix.

The warnings came after the Department of Health made clear there would be no new cash to fund prescribing under the framework.

Magnus Hird, head of prescribing at Blackpool PCT, said prescribing remained the 'biggest financial risk' to PCTs.

'Prescribing budgets are going to have to increase. But too much growth too soon could destabilise organisations and developments in other

areas. That could include commissioning of more local enhanced services which is

also essentially GP income.'

He added: 'The role of prescribing incentive schemes is unclear, even as to whether they are intended to continue under new GMS. Incentives for managing budgetary performance may well remain to remind everyone of the risk of prescribing spend.'

Nigel Barnes, prescribing lead for Walsall PCT, said his PCT was 'putting all the money into drugs' and planning a 10-12 per cent rise in the prescribing budget in 2004/5.

But he added: 'We have learned the hard way for balancing the budget. We have had to make cuts across the board in computer services, acute services and new positions have been frozen.'

RCGP prescribing spokes-man Dr Jim Kennedy, a GP in Hayes, Middlesex, said plough- ing cash into prescribing was not always the best option: 'PCTs should be making strategic decisions and saying, occasionally, we are not prepared to put so much towards a particular growth area.

'There is no point having great lipid levels, which looks good on paper ­ but poor angiography, no district nurses and no GPs.'

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