Hospitals fail to match GPs' cost-effective prescribing

By Tom Moberly, 31 October 2011

Hospital doctors are failing to match GPs' efforts to contain prescribing costs, with drug spends in hospitals rising three times faster than in primary care, official figures reveal.

Between 2009 and 2010, hospital prescribing costs rose by 8%, while the cost of prescribing in primary care rose by just 3%, Information Centre data show.

NHS spending on medicines in 2010 was £12.9bn, with hospital use accounting for 32% of this, up from 31% in 2009.

Wessex LMCs chief executive Dr Nigel Watson said GPs’ success in containing cost rises was not being matched in secondary care.

'I don’t think that hospital doctors are particularly aware of the cost of these drugs,' he said. ‘We sometimes notice that when people are discharged they are not on the most cost-effective drugs.’

GPC negotiator Dr Chaand Nagpaul said: ‘Prescribing in general practice has already been under a spotlight and been able to demonstrate cost-effective prescribing down to the individual prescriber.

‘We do not have the same level of information and scrutiny of individual doctors’ prescribing in hospitals.’

The data suggest secondary care prescribing costs rose despite hospitals increasingly pushing outpatient and discharge prescribing to GPs.

The cost of hospital prescribing dispensed in the community rose half as fast as other hospital prescribing in 2010. The data suggest GPs were forced to prescribe around £5m of medicines that could have been issued by hospital doctors on ‘FP10HP’ forms.

Dr Watson said it was inappropriate for hospitals to try to push prescribing onto GPs in this way. ‘Hospitals have done it to save costs,’ he said. ‘But if a patient needs treatment today, they should get it on a FP10HP.’

Dr Nagpaul added: ‘FP10HP ensures that responsibility lies with the prescriber. One of the greatest problems GPs face is patients turning up on their doorstep and being asked to prescribe on the assessment they did not make.’

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