NHS management in Scotland of GP prescribing has improved

The NHS in Scotland has improved how it manages prescribing in general practice during a period when it has faced considerable pressures. Spending on drugs has fallen in real terms over the past seven years despite the volume of prescriptions rising significantly.

GP prescribing accounts for 70 per cent of all NHS spending on drugs in Scotland. This amounts to almost £1 billion a year. Audit Scotland has today published Prescribing in general practice in Scotland, its third report on the subject. 

The report says the health service has improved its management of GP prescribing, and family doctors are getting more support and guidance on their prescribing. Spending fell by 11 per cent in real terms between 2004 and 2011, despite the volume of prescriptions rising by a third during that time.

The report says there is scope for further improvements and potential to save up to £26 million a year without affecting patient care. This could mostly be done through reducing waste and cutting the use of less suitable medicines.

Auditor General for Scotland, Caroline Gardner, said:

‘Most people in Scotland get a prescription from their family doctor at some point to treat or prevent an illness or help sustain a good quality of life. The NHS spends almost £1 billion a year on drugs prescribed in general practice. Since we last looked at GP prescribing, the volume of drugs prescribed has continued to rise but the NHS has significantly improved how it manages spending. This was during a period when there have been considerable pressures and constraints on the health service. 

‘It has achieved this through providing doctors with more support and guidance and using better information about what GPs are prescribing. Demand for prescriptions is likely to increase further and it’s important that the NHS continues to work with GPs to make sure patients get the drugs they need and spending is well managed.’

The health service now has better quality information on GPs’ prescribing than in the past. The report recommends NHS boards use this to target areas for further improvement, such as identifying where particular drugs are over- or under-prescribed and supporting GPs to review patients who take a number of different medicines.

In coming years a number of factors will affect prescribing and its associated spending, and it is difficult to forecast and quantify their long-term impact. These factors include new medicines and cheaper versions of existing drugs becoming available, Scotland’s ageing population, and lifestyle issues such as obesity, smoking and alcohol misuse and associated illnesses. The unclear long-term picture means it is important the NHS continues supporting cost-effective prescribing to get the most from the significant investment.