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Attempts to control general practice prescribing costs from 1975 to 1993 with particular reference to the impact of GP fundholding.

Edwards, Maria-Benedicta (1995) Attempts to control general practice prescribing costs from 1975 to 1993 with particular reference to the impact of GP fundholding. MPhil thesis, London School of Economics and Political Science.

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Under the 1991 NHS reforms some GPs have, for the first time, been given the opportunity to manage their own practice funds which includes an amount set for prescription drugs. This new budgetary scheme puts a ceiling on spending and gives practices the incentive to save on drugs and spend the money elsewhere. This study seeks to determine whether a series of measures, including the latter, have had any impact on prescribing trends. Prescribing trends of eight firstwave GP fundholding practices were compared with Family Health Service Authority (FHSA) averages. The study examines quarterly Prescribing, Analysis and CosT (PACT) data provided by the Prescription Pricing Authority (PPA) and sent to practices and FHSAs for at least one year prior to fundholding and two years post. From this data measurements for overall expenditure, number of items prescribed, average cost per patient, generic percentages and practice list size were recorded. Trends in national data were reviewed including overall net ingredient costs, total number of items prescribed and average cost per patient from 1975 to 1992 inclusive. Interviews with practices and FHSAs were conducted to determine what policies had been implemented to manage the drugs budget more effectively. The data indicates fundholding is broadly more successful than non- fundholding in restraining the drugs budget. Disaggregated data found the Indicative Prescribing Amount Scheme had not had the same impact as the GP Fundholding Scheme. GP fundholders did exceed their drugs budgets but, these overspends were less than for non- fundholding practices. Prior to fundholding few practices had implemented cost-containment strategies. Most had a general policy of generic prescribing but, pursued this more rigorously and introduced a whole range of other cost-containment strategies after fundholding. Cash limited budgets and financial incentives appear to have been sufficient to encourage GPs to seriously consider their prescribing costs.

Item Type: Thesis (MPhil)
Uncontrolled Keywords: Sociology, Public and Social Welfare, Health Sciences, Health Care Management
Sets: Collections > ProQuest Etheses

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