Financial incentives offered to GPs to save money by reducing the number of drugs prescribed to frail elderly patients in care homes have been labelled a “bribe” by critics.
GP surgeries in Oxfordshire have been told they will receive half of the cash saved by a scheme to cut costs by handing out fewer prescriptions to frail patients.
The initiative aims to save the area’s NHS bosses a total of £1.45m – or £2 per patient – of which at least £1 per patient will be returned to family doctors who help the plans succeed, reported Pulse magazine.
All of the county’s GP practices are invited to review how many drugs are prescribed to frail care home residents over 70 “without impacting on the quality of patient care”.
But the Berkshire, Buckinghamshire and Oxfordshire local medical committee is advising its GPs not to sign up to the scheme, which doctors have said should focus on improving patient care rather than reducing costs.
Joyce Robins, from the pressure group Patient Concern, told The Times the incentive “feels a bit like a bribe”, adding: “You would like to think patient care was their main priority, not cost savings.”
Concerns have been raised previously that older patients may be taking too many unnecessary drugs, which could lead to complications if they react badly with each other.
A recent review of nearly 2,000 patients over 75 in Croydon found that, on average, they had been prescribed six different drugs, with hundreds of prescriptions cancelled after they were reassessed.
And Keith Ridge, NHS England’s chief pharmaceutical officer, said last year a fifth of medicines prescribed to frail elderly people in care homes were pointless.
The NHS commissioning group in Oxfordshire told Pulse taking multiple drugs for different conditions could cause “many potential problems, including side effects, non-adherence and medication waste”.
The scheme would go ahead because it “offers the right balance of incentive to the practices whilst also evidencing good governance of quality and funding”, they said.
But Dr Andrew Green, the British Medical Association’s head of GP clinical work and prescriptions, said: “It might well be that the result is cutting costs, but that mustn’t be the aim.
“The aims must be to get appropriate care to the right patient.”
