CCG claims stopping pharmacy managed repeats saved £2m
The first clinical commissioning group (CCG) to block pharmacies from managing repeat prescriptions says the scheme has saved £2 million over two years and given patients “considerable benefits”.
Luton CCG calculated that “in broad terms” rolling out the scheme across the whole country could save “the entire NHS over £500m”, in an evaluation published in September.
A spokesperson told C+D last week (October 27) that it has already scheduled discussions with NHS England, as part of its recommendation for “a national programme of work” to maximise the savings.
Since Luton first reported successful savings from its initiative– initially of £400,000 in the four months to October 2015 – other CCGs have rushed to implement similar schemes.
Last month, a C+D investigation found almost four in 10 CCGs in England plan to stop pharmacies from ordering repeat prescriptions on behalf of patients. A similar proportion either have, or are considering, instructing patients to order repeat prescriptions directly from their GP.
These CCGs estimate their schemes will make average savings of £1.4m, C+D’s investigation found.
In its evaluation, Luton CCG concluded that its scheme had “shown that transformational change can have [a] significant impact”.
LPC not convinced
But Bedfordshire local pharmaceutical committee (LPC) chair Coll Michaels told C+D the savings “were down to many variables” the CCG had worked on, such as changing prescriptions from seven to 28 days, better GP education, and initiatives to increase the uptake of the electronic prescription service.
The reduction in managed repeats is also affecting his profits, as the number of items his pharmacy dispenses is down around 4% compared with before the scheme was introduced.
Bedfordshire LPC chief officer Gerald Zeidman told C+D: “It’s worrying that the scheme has spread without the full facts being published.”
“The report talks about cost, but not about the good practice in pharmacies and the help they provide to GP practices,” he said last week (October 26). “There’s nothing positive [in the report about pharmacies].”
“All of the pharmacies in Luton have been tarred with a similar brush. We did everything we could as an LPC to improve practices – regrettably they closed the door. The impression I have is that they had their idea and wanted to run with it.”
No benefits for pharmacies
The 45 pharmacies in the Luton area are yet to gain any benefits from the scheme, said Mr Zeidman, who added that relationships between contractors, GPs and the CCG had soured.
Luton CCG told C+D it will review the impact of the scheme on community pharmacy services, such as the new medicine service and medicines use reviews. But the CCG stood by its scheme, adding it is “confident the savings are attributable to the change in third party requests”.
“Prior to implementing these changes, there was high annual growth in spend in Luton on medicines. Following this change, benchmarking against national prescribing trends has identified Luton as an outlier with lower growth in medicines spend,” it said.
“There have been significant financial savings, and safety improvements for patients,” the CCG added.
What did the Luton evaluation find?
An audit in 18 practices in Luton between October 2013 and January 2014 found 29% of items ordered by community pharmacies were found to be “over-ordered”, which cost a “conservative estimate” of more than £2m a year.
The CCG also claims there were safety concerns with items ordered by pharmacies. However, the LPC challenges these findings.
The CCG says its “bold step” resulted in estimated savings of £2m over two years (equal to 7% of its annual primary care prescribing budget), and “evidence of considerable benefits to patients”.
Applying the Luton figures at a national level could amount to more than £500m in savings to the entire NHS, so “warrants serious consideration by NHS leadership”.
The CCG received 13 complaints and 69 queries from concerned patients – and a quarter of the 250 calls to a patient helpline were about repeat prescriptions.
Source: Repeat prescription services, final report, Luton CCG, September 2016
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