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Antibiotic prescribing targets in the GP contract? A medicolegal nightmare

True, it’s probably just an embryonic thought. But I’d give it a shot of mifepristone just in case. Because the recently reported idea of putting antibiotic prescribing targets into the GP contract is – even allowing for the mad, mad, mad, mad primary care world we currently inhabit – significantly off the scale of one to insane.

On the one hand, our terms of service oblige us to prescribe and refer when appropriate. On the other, targets, enhanced services and other initiatives pressurise us to do less of both, or else.  And all that to a backdrop of media and politicians blaming us for antibiotic Armageddon and an over-stretched NHS, while defence body subs make our eyes bleed and we click to the fact that you never get complained about for doing too much.

Difficult to reconcile that little lot, isn’t it? No, not difficult. Impossible.

I sincerely hope that, when whoever dreamed up this latest germ of an idea gets hit with a germ of his own, his GP will explain that the options for his pneumonia are, not to prescribe antibiotics or not to send him to hospital.

True, it’ll probably screw the GP’s career and potentially kill the patient. But at least it’ll save the NHS the cost of some clarithromycin.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield