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CCGs ‘crossing the line’ in ‘ambitious’ plan to cut prescribing by 15%


25 November 2016

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Healthcare leaders in Suffolk and North East Essex are looking to cut prescribing costs by 15% according to local sustainability and transformation plans (STPs).

The STP, which is lead by Nick Hulme, chief executive of Ipswich Hospital NHS Trust, aims to save £32.5m on primary care prescribing by 2020/21, amounting to a 15% cut.

Healthcare leaders in Suffolk and North East Essex are looking to cut prescribing costs by 15% according to local sustainability and transformation plans (STPs).

The STP, which is lead by Nick Hulme, chief executive of Ipswich Hospital NHS Trust, aims to save £32.5m on primary care prescribing by 2020/21, amounting to a 15% cut.

The plan said this would be enabled by “a year-on-year medicines management saving based on product switches, improved prescribing and reduced item cost” and “a clear focus on reducing variation in prescribing by supporting outlier practices”.

Dr Brian Balmer, chair of Essex Local Medical Committee, said he has not seen any details on how the savings will be made but described the plan as “very ambitious”.

He added that Essex has a “long history” of medicines management programmes, “so it’s not new, which is why the saving is likely to be even more difficult ahead”.

It comes as official data from NHS Digital, published last week, revealed that the cost of medicines dispensed in primary care has increased by just 4.6% in five years, compared to an 81.8% increase in hospitals over the same time.

The report also found that as a proportion of the overall NHS expenditure on medicines, medicines dispensed in primary care has fallen from 66.5% to 53.9% in five years.

But despite this, the Buckinghamshire, Oxfordshire and Berkshire West STP is also looking to cut back on prescribing with an ambition to save £15m (7%) from the £213m GP prescribing budget by 2020/21.

The savings, which amount to £7 per patient, are described in the plan as “business as usual” CCG savings.

An Oxfordshire CCG spokesperson said the region “sees opportunities to make significant savings” by “focusing on the prevention of ill-health… and therefore reducing the need to prescribe”.

They added: “At this very early stage and before the plan has been formally approved and published, the fine detail is yet to be developed.”

But Dr Andrew Green, prescribing lead for the General Practioners Committee, said that “GPs have cut their prescribing costs as much as they can” over recent years, including switching branded drugs to generics.

He said: “In many areas CCGs are crossing the line between encouraging sensible cost-effectiveness and enticing GPs to break the regulations that govern their work.

“I simply do not believe that cuts of 7% can be made without denying patients the medicines that they need.”

Dr Green added that: “Over the last five years the increase in primary care prescribing costs has been marginal when compared with those incurred from secondary care, even though much of the high-cost prescribing that we do is originating from hospital recommendations.

The Buckinghamshire, Oxfordshire and Berkshire West STP also commits to savings of £1m in “other primary care” and £2m from community health services as part of an overall savings target of £384m by 2020/21.

The largest commissioning saving, of £45m, is to come from acute care. And it says £10m will be invested in general practice via GP Forward View funding streams, including for extending access.

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