GPs are being dictated to by primary care organisations on the new QOF quality and productivity indicators, with many practices being told to focus on certain areas of prescribing and placed under pressure to deliver major savings.
Guidance from the GPC and NHS Employers on the new QOF indicators states GP practices are expected to propose three areas of prescribing to focus on after conducting a peer review with local colleagues.
But LMC leaders have accused PCOs of misusing the QOF indicators, introduced in April, as a performance management tool, by stipulating what areas GPs should focus on in their reviews.
Dr Robert Morley, secretary of Birmingham LMC, told Pulse: ‘PCTs in Birmingham are more or less insisting how practices use prescribing indicators – particularly on statins, ACE inhibitors and proton pump inhibitors.
‘This is about short-term financial gains, but it may have knock-on effects by switching drug regimes – from the drug being less effective, to patients stopping their medication, to extra work for practices in monitoring changes.'
Dr Rob Barnett, secretary of Liverpool LMC, said: ‘Medicines management has been giving confusing advice to practices, saying they must only prescribe a very limited range of medicines or they will fail the QOF indicators. I think they have over-stepped the mark in being too prescriptive.'
A Department of Health spokesperson said: ‘Doctors must always decide what medicines it is clinically appropriate to prescribe for individual patients. However, it is crucial that general practice is incentivised to make most appropriate use of wider NHS resources.'