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NHS reforms risk ‘contaminating’ GP prescribing decisions

The ongoing NHS reforms risk a commercial bias influencing GP prescribing decisions and an increase in ‘drug tourism', say the GP authors of a new report.

The report by think tank The King's Fund into the quality of GP prescribing found wide variation in prescribing across the 152 PCTs, and argued ‘weaknesses' in the proposed health reforms could result in GP prescribing becoming more expensive and less fair under the NHS reforms

The report warned ‘the advice to the consortia might not be as well-informed as that provided by experienced PCT advisers, although the consortia will have the potential to buy in this expertise, if they see the value of this support and can afford it.'

This could mean that ‘there is a risk clinical commissioning groups might buy in support with a particular commercial bias, rather than the ethos of the NHS.'

The report also suggests that because there are likely to be many more CCGs than there were PCTs, variations in care are likely to be more pronounced.

‘This may increase inequity of care and as patients will have greater choice in where they register for primary care services they may shop around for the treatments they prefer,' says the report.

‘Practices may be torn between making themselves popular to patients seeking the treatments they want and ensuring they provide adequately for overall need, given the increasing financial restraints.'

Dr Martin Duerden, a GP in Conwy, Wales and one of the report's authors, told Pulse: ‘Commercial interests risk contaminating advice and already we are seeing various private enterprises beginning to circle and looking at how they might work more closely with CCGs. I'm concerned this would not be impartial and provide best value.'

Dr Duerden, the RCGP clinical champion for prescribing, said: ‘We might get lots of different systems creating postcode lotteries and drug tourism and that needs to be handled very carefully because that is essentially unfair.'


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