Consortia may limit GPs' prescribing freedom

Consortia could have the legal power to impose referral and prescribing decisions on their member practices, a senior GP has warned.

Dr Jenner: 'Practices could have to abide by the consortium's rules'
Dr Jenner: 'Practices could have to abide by the consortium's rules'

NHS Alliance GMS/PMS lead, Dr David Jenner, said that clause 24(d) of the Health Bill could mean that, by law, GPs have to follow consortia rulings. Dr Jenner said that, depending on secondary legislation, it could be 'a statutory duty for practices to follow the aims of consortia'.

Dr Jenner warned that the clause could allow consortia to create local formularies.

'This could herald a situation where practices have to abide by the consortium's rules for referral and prescribing,' he said.

The consequences of this clause should 'not be ignored', he said. Consortium decisions 'could potentially conflict with the professional duty to provide the best care for the patient'.

Dr Jenner raised concerns over the potential conflict between consortium decisions and GMC guidance. The GMC 'can't encourage you to break the law', he said. But if GPs are legally required to put the consortium first, GMC guidance may have to readdress 'the balance between the needs of the individual patient and the needs of the general population', he said.

The GMC recently released a draft document suggesting possible guidance changes to address the potential conflict between GPs' management decisions and their primary duty to patients (GP, 4 March).

But GPC deputy chairman Dr Richard Vautrey said that, although GPs may be encouraged to follow formularies locally, it would be 'very unlikely' that they would be bound by law to follow consortium rulings.

Consortia, like PCTs, may 'try to encourage a unified policy', he said. But he added: 'GPs must always be able to prescribe for the needs of the patient.'

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