The tittle just about says everything. Same old – same old!
Having spent an hour or so reading a ‘hot of the press’ guide for GPs and GP commissioners I am truly disappointed in lack of innovation in the whole document. When leadership is needed the knowledgeable turn out a document defending all that is done today with the need to do extra things. Sooner or later someone will say ‘hold on a minute – who do they think they are kidding’.
The bit that sticks in my mind is ‘Many PCTs have historically used their prescribing budget to fund medicines management teams’ – so is this the thinking behind a document in which the first two bullet points in the introduction relates to the prescribing costs.
Two important reminders – the Chief Pharmacist has not fully clarified the medicines optimisation agenda, but this is the future I want and it is not focussed on saving money in the prescribing budget. The NAO report on prescribing costs in primary care is 5 years old – need I say more….
So here are a couple of thoughts:
Fund the medicines optimisation team through the commissioning budget. Change the focus from saving money in prescribing to reducing referrals, reducing non-planned admissions and the cost of planned admissions. If you take this as the starting point the whole conversation changes and other things fit in. So is this clear – the currency is not £ prescribing spend – the currency is referral, admission, episode of care.
Scrap prescribing incentive schemes – they fundamentally wrong. Even NICE is taking it out of the QoF.
Stop talking about providing practice support – the idea of throwing good money after bad is dead. Set the standard and help practices employ their own practice support. There are some great examples around.
Truly believe that integration is essential and ensure that the prescribing agenda supports this. See my blog on ‘discovery’ for just one example.
If it is a statutory responsibility – just say – do it.
Rewrite the recommendations
Oh and I should say the only example that rocked my boat was from Croydon. A pilot scheme in nursing homes. But please don’t lead with drug costs down by £51,472 – just say hospital admissions down by 106 reducing expenditure by a mouthwatering £372,750. Medicines Optimisation at its best! Hmmm Barbara if that was you – hero of the week!