Within the Twickenham/Teddington/Hampton PCG (TTH) we are fortunate in
having had a variety of different kinds of pharmaceutical advice over the
last two years. Our HA pharmaceutical adviser has been honing her EPACT
skills, through Multifund we have an independent financial adviser, a group
of independent funds have an "in house" pharmacist who advises, and my
practice were funded to try the effect of having a more intensive form of
in house support - 15 hours a week of dedicated help from a pharmacist, who
discusses policies, collates information, but also actually runs our repeat
prescribing system. This latter model seems to have proved to be most
cost-effective, producing savings of ca. 10% on budget. The kind of advice
you can get from analysis of PACT, no longer requires having an independent
adviser - and anyway we found many practices didn't have the time or sense
of "ownership" to implement the recommended changes. So our game plan is
to vire 1% of our PCG drug budget and use that to employ a team of
pharmacists, each rotating round a small group of practices, meeting the
GPs regularly, and getting stuck in on ground level rather than giving
stratospheric advice.
One major motivation for GPs in the new PCG era is that the drug incentive
scheme is now much more flexible: HA Pharmaceutical advisers are free to
reward good prescribing whether that means a higher spend or a saving. And
the incentive scheme looks likely to be about the only financial "carrot"
available to GPs to help them recoup the lost support of management
allowance.
So in brief, DON'T join a drug company. Sell yourself to a PCG instead.
Andrew Wright, Deputy Chair, TTH Locality Interim GP Board
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