Diverting hospital prescribing to GPs costs NHS more, GPC warns

Moves to divert hospital prescribing to primary care are increasing NHS costs and inappropriately shifting clinical responsibility, experts have warned.

Prescriptions issued in the community have risen by 23 per cent (Photograph: Jason Heath Lancy)
Prescriptions issued in the community have risen by 23 per cent (Photograph: Jason Heath Lancy)

GPC prescribing lead Dr Bill Beeby said pressure to move prescribing to primary care had increased over the past 18 months.

'I have absolutely no doubt that there is a huge push towards trusts pushing prescribing into primary care,' he said. 'It is absolutely aimed at reducing costs.'

NHS Information figures show that, over the past four years, prescriptions issued in the community have risen 23 per cent, while those issued in hospital outpatients have fallen by 2 per cent.

Dr Beeby said, as well as moving workload and clinical responsibility, such action introduced inefficiencies into the healthcare system and ended up costing the NHS more.

Any money saved on hospital drug budgets would be outweighed by the cost of staff time spent on unnecessary appointments and paperwork, he pointed out. It was also inappropriate for GPs to continue most off-label prescribing initiating in hospital, he said.

Dr Michael Devlin, deputy head of advisory services at the MDU, said GPs needed to remember that they are legally responsible for any prescription they sign.

GPs may, he said, involve the LMC so local agreements can be negotiated. 'It may be advisable or necessary in some situations to agree a shared care protocol.

'Hospital colleagues should tell the GP the results of investigations and treatments provided which are necessary for the patient's ongoing care,' he said.

'The GP may need to discuss the best way forward with hospital colleagues, in order to satisfy themselves about any prescription required, and to ensure the patient receives the best possible care.'

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