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GPs facing brunt of patient complaints due to OTC prescribing cuts

Exclusive GPs in the UK are having to handle an increasing volume of patient complaints as they have been forced to ration over-the-counter prescriptions, Pulse can reveal.

Six out of 10 GPs have reduced OTC prescriptions in the past year in line with NHS England guidance, a new survey of more than 800 GPs has found.

But the cut in OTC prescriptions has prompted a sharp increase in patient complaints, with half of GPs who have cut OTC prescriptions saying that patients had raised the issue with them.

The BMA’s GP Committee said this has left GPs ‘unfairly at the sharp end of understandable patient disquiet’.

GPs said it is adding workload as they have to explain to patients why they are cutting the medication.

NHS England issued guidance to curb over the counter prescriptions of medicines for conditions such as constipation, diarrhoea and athlete’s foot in March. It claimed that that putting a halt to the routine prescribing of these medicines will save almost £100m to be reinvested in front-line services.

But the push to cut prescriptions of OTC medicines has been controversial with GP leaders.

Last year the BMA’s GP Committee warned that the Government needed to draw up a blacklist in order to reduce OTC prescribing, to avoid GPs risking a breach of contract.

Dr Nicola Cooper, a GP in South Tees, told Pulse that the prescribing cuts are a ‘constant source of lengthy consulting and complaints’.

She said: ‘Our practice is now trying to devise a method for giving clinical advice about OTC products for how/when to use them, which is already adding to the time it has taken to discuss why I can’t prescribe it.’

Another GP, speaking anonymously to Pulse, highlighted the time it could take to resolve patient complaints around the refusal to prescribe OTC medication.

He said: ‘My first complaint was me not prescribing paracetamol and took nine months to resolve and that put me off challenging patients’ entitlement attitude.’

Meanwhile, others argued that while it was understandable for NHS England to want to curb spending, the impact would be felt by those patients most in need.

Dr Richard Greenway, a GP near Bristol, said patients have complained ‘because some don’t have access to pharmacies’, with his dispensing practice located in a rural area.

He said: ‘Although we are happy to try to decrease prescribing spend – and our practice has a historically low spend – I feel we need to take into account all patients’ needs.’

He added: ‘Many do not have access to cars/supermarkets for low price OTC medications, and as usual it is the least well off, and illest who stand to lose out.’

Dr Harry Minas, a GP in South Gloucestershire, said: ‘While understandably the Government wishes to reduce drugs spending, the risk is that we are passing the cost to lower rate taxpayers.

’Young families with children and incomes stretched due to rising cost and austerity having to fork out for OTC items whose prices are higher than NHS ones. I can see the argument from both sides but feel stuck in the crossfire.’

GPC chair Dr Richard Vautrey told Pulse: ‘Everyone wants to make best use of scarce NHS resources but far too little has been done to make patients aware about NHS England’s and CCG’s aims for a move to buying these products over the counter.

‘This has therefore left GPs unfairly at the sharp end of understandable patient disquiet. NHS England and CCGs need to do far more not only to educate and inform patients, but also to provide much stronger support for prescribers.’

Have you reduced OTC prescribing in the past 12 months?

Yes – 59.76%

No – 31.92%

Don’t know – 8.32%

If you have reduced OTC prescribing, have patients complained?

Yes – 54.13%

No – 40.17%

Don’t know – 5.70%

The survey was launched on 12 April 2018, collating responses using the SurveyMonkey tool. The 28 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 589 GPs answered question 1 and 351 answered question 2.