Editorial - GPs must be free to make prescribing decisions

This week we reveal that GPs have been barred from prescribing certain NICE-approved drugs because PCTs believe them to be too costly. This is a clear example of how budget cuts and financial pressures are making it difficult for frontline medical staff to follow best practice. It also makes a mockery of the NHS's system for approving and recommending drugs.

NICE is not always popular, but this is because it makes difficult decisions about what can and cannot be afforded in a cash-limited NHS. It uses the latest evidence to set standards and recommend treatments based on efficacy, cost and safety. This should, in theory, end the postcode lottery and mean such decisions are not left to local managers.

However, time and again PCTs choose to ignore NICE and establish local policies, almost always because of cost. Such local policies often interfere with GPs' abilities to provide their patients with the best quality care. If something is recommended by NICE, it should be available to patients regardless of where they live.

GPs accept that they need to be aware of the costs of their actions. In particular, they understand the importance of prescribing cost-effectively. However, they should not be placed in a position where they are expected to put cost ahead of the best interests of the patient in front of them. They must be allowed to make decisions about prescribing - and any other treatment for that matter - based on the individual patient's needs.

If we are reaching a point where financial restrictions are hampering GPs from following best practice, the government needs to step in. Ministers have been quick to act in the past when PCTs blocked high-profile cancer drugs, and last week health secretary Andrew Lansley took steps to reduce waiting times that have been rising in the wake of budget constraints. We need a similar no-nonsense approach here.

It is right for the NHS to be mindful of the drugs bill, but the DoH must put an end to drugs 'blacklists' if they are not supported by clinical evidence and prevent patients accessing the medicines they need.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

£20 notes spread out

VAT trap for PCNs could strip millions of pounds from general practice

Tens of millions of pounds could be stripped from general practice because work carried...

Talking General Practice logo

Podcast: Is the BMA representing GPs effectively, why GPs face a pension tax hit, and views on the workload crisis

In our regular news review the team discusses representation of GPs, a new survey...

Man sleeping

NICE guidance on insomnia backs app to replace sleeping pills

Hundreds of thousands of people with insomnia could be offered treatment via a mobile...

Health worker prepares a dose of COVID-19 vaccine

JCVI backs autumn COVID-19 booster campaign for high-risk adults and NHS staff

Frontline health and social care staff and adults at increased risk of severe illness...

GP consultation

Government accused of 'misleading' claims on general practice workforce

GP leaders have accused the government of making misleading claims about the general...

Consulting room door

LMC calls for enhanced access to be scrapped after abuse forces practice to close reception

A Midlands LMC has backed a practice forced to close its reception desk after abuse...