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We need a pseudoprescribing disincentive scheme

We need a pseudoprescribing disincentive scheme

Copperfield lets off some steam around the scheme for GPs to prescribe heating to patients

What have all the following got in common?

  • Books
  • Dance
  • Museums
  • Walking
  • Cycling
  • Nature
  • Art
  • Exercice
  • Boilers
  • Archaeology
  • Singing
  • Dog walking
  • Fruit & veg
  • Bird watching.

Correct. They are all things GPs can, could or should ‘prescribe’ for their patients. I’ve not made any of these up. You can append ‘on prescription’ to each, and Google will find an example. And now you can add to that list, ‘heating’.

Incredible. It’s only a matter of time before the ‘on prescription’ concept is extended to air, frogs and poetry. In fact, poetry’s already there, I just checked. The only thing I can never seem to prescribe is medication, thanks to prescribing-switch software, OTC initiatives and supply shortages.

Of course, these aren’t actual prescriptions, are they? They’re just snappy titles/lazy shorthand for schemes where GPs provide some kind of pseudoprescription document enabling the patient to access local facilities, usually at a subsidy. Because it’s good for their health, right? Admittedly, the medical need might be dubious and the actual benefit tenuous (me singing certainly wouldn’t help me and would definitely harm others). But that’s the idea.

What I don’t get is why this requires GP time and endorsement. If a patient thinks a spot of archaeology might ease their fibromyalgia – unlikely, unless they dig up some tramadol – then so be it. But why should I be the arbiter of access to soft psychosocial benefits? And why would I want to collude in infantilising my patients and fostering further dependence on GPs?

So please, let’s ban this process, and that starts by banning the phrase ‘GPs to provide XXX on prescription’. Otherwise, I prescribe a riot.

Dr Copperfield is a GP in Essex. Read more of his blogs here



Please note, only GPs are permitted to add comments to articles

Decorum Est 11 September, 2023 4:28 pm

It’s amazing the things you can prescribe?
Meanwhile, I tried to buy Aspirin 75mgs soluble (tenuous benefit I know but hx of CVA/TIA in family and happily taking same for years), and NyoungLpharmacist refused to sell me some, despite me being a qualified doctor for at least twenty years before she was born.
The World has become a difficult place to understand.

Nick Mann 11 September, 2023 6:27 pm

Politically, I expect this presages the expansion of personal budgets, activating patient choice. Then NHSE complains we’re offering too many ‘inappropriate’ appointments.
No estimation of the huge demand inflation. No doubt we’ll be issued with vouchers: BOGOF.
GPs to do…less and less of our actual job. There was a time, not so long ago, when evidence for prospective interventions would be duly peer reviewed, any pilots evaluated and results disseminated for further review before implementation. This is ‘transformation’.

Dave Haddock 11 September, 2023 6:37 pm

Apparently immortality is also available on prescription; at least it’s existence is implied by the inevitable who’s-to-blame game when anyone dies of anything but extreme old age.

Colin Turner 11 September, 2023 6:41 pm

Please don’t prescribe a remote riot.Not”Nice”
As usual Coppers is bang on – but omitted to nail the never ending ( and changing- like the mists of time) forms, tick box pro- formas etc…that this creates. Jobs for the boys- better directed to the Boy Scouts.

Simon Gilbert 13 September, 2023 3:21 pm

The NHS is becoming an executive branch of a semi centralised system of state allocation of resources.

paul cundy 14 September, 2023 8:28 am

Hilarious, keep the rioting going!
Paul C

George Forrest 14 September, 2023 1:48 pm

As soon as any obvious medical issue has been excluded, one of these options (plus a few more perhaps? New job/dog/relationship/holiday etc.) could be picked at random form a large spinning “wheel of wellbeing”…
Then, off you go! ..and good luck!

Charles Perrott 16 September, 2023 10:07 am

At least you won’t come under the cosh for prescribing too much archaeology.

Truth Finder 18 September, 2023 5:15 pm

Brilliant. We can prescribe all sorts except what we have been trained to prescribe. Please write a column on the mandatory and shockingly I found out we have to do yearly almost useless training on woke bits and common sense “training” on patients/conditions like LD we hardly see. This is driving hard working doctors out.