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Pharmacists will be stopped from ordering repeat prescriptions for patients if proposals from some London clinical commissioning groups (CCGs) are implemented.
The North West London Collaboration of CCGs has proposed that all the 2 million residents who live on their patch will have to order their own repeat prescriptions as part of a drive to save £135m each year to balance its budget.
The CCGs also want GPs to stop prescribing some drugs that can be bought over the counter and to ask patients if they are willing to buy some medicines rather than having them prescribed.
The CCGs describe these measures as the ‘first step’ in their attempt to cut their annual budget by 5%.
Under the proposals, patients and their carers will be asked to order their own repeat prescriptions by using repeat prescription slips, via GP practices’ online ordering systems, or by using mobile phone apps.
In the proposals, the CCGs claim that medicines ordered on patients’ behalf risk unintended harm because the patients may get drugs they do not need or do not intend to take.
Pharmacies will be able to provide a repeat prescription service for ‘a few’ patients who are unable to order their own prescriptions and who do not have a carer who could do it for them.
A list of drugs that will not be prescribed by GPs has been drawn up in conjunction with local doctors. It includes colic treatments, cough and cold remedies, oral rehydration sachets and travel sickness tablets.
GPs will be able to prescribe drugs on the list if there are ‘compelling medical reasons’ but the CCGs say they “expect there to be very few prescriptions for them in the future”.
Under the proposals, family doctors will have to ask patients if they are prepared to buy some medicines or products that are available without a prescription. These include paracetamol, ibuprofen, acne treatment, antihistamines, laxatives and threadworm tablets.
A total of £15m was spent across the CCGs last year on prescriptions for these products.
Middlesex Pharmaceutical Group (MPC), which represents local pharmaceutical committees across a number of the London boroughs involved, including Hammersmith and Fulham, Ealing, Hounslow, Brent and Harrow, has objected to the proposals.
Chief executive of the MPC Michael Levitan said the proposal to stop the pharmacy ordering service for repeat prescriptions could make it extremely difficult for some patients to get the medicines they need.
“We are opposed to anything that will make it harder for patients to get their medicines in a simple and orderly fashion,” he said.
“There is always going to be a degree of wastage, whatever system you use. But this is about workload as well, and at the moment pharmacists are taking on a great deal of the workload from GP practices without being rewarded in any way. This is only likely to increase the workload on GP practices.”
Mr Levitan said that if all three proposals were implemented, then already significant inequalities in access to medicine would increase.
A decision on the proposals is due to be taken by North West London CCGs next month.
