New targets for crackdown on GP prescribing revealed

By Nigel Praities

NHS prescribing advisors have devised a wide-ranging crackdown on GP prescribing, as part of the drive to achieve the £20 billion savings required of the health service by 2013.

The plans – put together by the National Prescribing Centre and circulated to PCT managers – are designed to clamp down on the use of expensive medicines such as ezetimibe and obesity drugs in primary care.

They encourage trusts to ensure GPs are assessing patients properly before handing out medicines and in some cases to prevent ‘over-implementation' of NICE guidance where it is proving costly.

The report admits in many areas the cost gains may be ‘small', argues but that the overall national cost savings could ‘become very significant'.

The 15 areas identified for savings include reducing the prescribing of broad-spectrum antibiotics, long-acting insulin analogues and the use of orlistat for weight loss.

The report also discourages the over-treatment of patients with high-dose corticosteroids, the ‘over-implementation' of NICE guidance in the case of ezetimibe and encourages GPs to follow NICE guidance when prescribing alendronate and antipsychotics.

Introducing the report, Dr Neil Maskrey, director of evidence-based therapeutics at the National Prescribing Centre, said the advice would improve the efficiency of primary care prescribing and improve patient care.

‘The evidence base for all the topics identified has been carefully examined to ensure that safety and clinical effectiveness would be maintained, or in some cases even improved, if they were incorporated into prescribing practice with less variation than at present,' he said.

Peter Rowe, lead for the Department of Health's QIPP initiative, said the document represented a ‘important early opportunity' to make efficiencies in the NHS and would be an important area for GP consortiums to look at as they take over commissioning from PCTs.

1. Renin-angiotensin system drugs
2. Statins
3. Newer hypoglycaemics
4. PPIs
5. NSAIDs
6. Low-dose antipsychotics
7. Long-acting insulin analogues
8. Self-monitoring of blood glucose
9. Clopidogrel
10. Ezetimibe
11. Broad-spectrum antibiotics
12. Hypnotics
13. Orlistat
14. High-dose inhaled corticosteriods
15. Alendronate

Source: National Prescribing Centre, Key Therapeutic Topics 2010/11

Click here to read the full report from the National Prescribing Centre