Editorial: Where is the value in limiting prescriptions?

Science prides itself on being evidence-based. Can you imagine introducing a new drug without rigorous testing?

Last month GP reported that PCTs were introducing 28-day time limits on GP prescriptions to save money (31 October). In practice this meant that GPs were urged to issue prescriptions for no more than 28 days' supply where possible.

The good news in these credit crunch-obsessed times is that there is presumably a cost saving where patients find a 28-day supply will suffice and any additional medicine they would have been given under the old regime is no longer wasted.

But, today GP can reveal that more than 40 per cent of PCTs have introduced 28-day prescribing policies without any assessment of their impact on patient care.

Of 46 PCTs who responded to GP's Freedom of Information request, 45 per cent had introduced guidance for GPs to limit scrips, with just one carrying out any assessment on whether the guidance had affected the number of scrips patients were collecting or the total GPs were issuing.

This is an unquestionable two fingers to the ideal of evidence-based medicine.

Presumably, in an NHS obsessed with consultations and focus groups, patient representatives are happy though? Wrong.

Asthma UK warns that patients will pay more for the same amount of medicine.

Patient Concern says that those with long-term conditions such as asthma face more frequent trips to GPs, potentially deterring them from taking the medication they need.

Buckinghamshire GP Dr Andrew Webber says: 'If there is evidence, we should be able to find it and take a look at it.'

The process of piloting schemes, adopting those that are successful and dropping those that fail is commonplace in the NHS, and it is a far better system for it. Why should we override that procedure in the rush to limit scrips and to save money?

Let's junk all but a few of these schemes and run them as pilots until we can prove that they are of value. Patients deserve nothing less.

More opinion online
Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs. This is what the team had to say this week

"Little progress made on PBC When PBC launched, the NHS was in financial deficit. PCTs were trying to claw back funds wherever possible. It's not surprising that GPs were wary about whether they would ever see any of the money they saved."

"COPD overhaul is overdue Staffing in many COPD assessment units remains below the level recommended by the RCP; insufficient information is given to COPD patients; and the provision of palliative care services is highly variable."

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