GPs’ prescription overspend – By Local Democracy Reporter Daniel Mumby

Somerset GPs could end up exceeding their annual budget for prescriptions by over £4million this year.

The Somerset Integrated Care System (ICS), which brings together numerous NHS bodies across the county, plans for a certain number of prescriptions to be issued by each doctors’ surgery as part of its annual budget.

The ICS has warned that its prescription budget could be exceeded by more than £4m, blaming a shortage of pharmacists, rising costs and the long-term impact of the coronavirus pandemic.

Health bosses have said they will work with “as best as possible practice” to try and reduce this projected overspend.

The overspend was revealed in a risk management report which came before the Somerset Integrated Care Board in Yeovil on 25th May.

The budgets are set by the medicines management team, which allocated funding to each GP practice and monitors their performance throughout the year (i.e. how many prescriptions are issued and at what cost).

While Somerset currently has the lowest prescribing costs in the south west, the ICS has been working to “reduce prescribing of over-the-counter medicines of low value and those causing harm and admissions.”

A lack of pharmacists across the UK has “reduced support to practices” to improve their prescribing ability, and has also reduced the number of structured medication reviews (SMRs), which may lead to individual patients being taken off prescriptions where they are deemed to be ineffective.

A spokesman said, “The coronavirus pandemic has made controlling the financial costs of prescribing less of a priority for GP practices.

“The forecast overspend stands at more than £4.3m at the end of February 2023. Recent increases in generic prices have added to the cost.”

Mike Hewitson, a practising pharmacist, handles numerous prescriptions from Somerset patients from his two pharmacies in Beaminster and Sherborne.

Mr Hewiton, who lives in Norton-sub-Hamdon near Yeovil, said the national shortage of pharmacists was “only half of the story”.

He elaborated, “There are huge inflationary pressures on the medicine supply chain which are affecting all areas.

“As pharmacists, we tend to see increase in medicines costs a long way ahead of the NHS.

“Costs have risen markedly since autumn last year, and this will have an impact on ICS budgets, but I don’t know if they have budgeted for this. I expect all prescribing budgets to be under pressure for 2023/24.

“GP practices are quite rightly focused on seeing and treating patients, which means they are potentially less able to manage costs associated with prescriptions.”

Mr Hewitson said that trying to reduce the prescription of over-the-counter medicines was difficult in light of the cost-of-living crisis.

He said, “Patients are already struggling with the cost-of-living crisis and are being asked to buy medicines which are available over-the-counter for themselves.

“For patients who are on limited budgets such as pensioners, or families on benefits it is not always easy for them to be able to afford to buy over-the-counter medicines, especially as the prices of those medicines have been rising very quickly in many cases.”