The right prescription for south Manchester

Many of my blogs have outlined the financial challenge we face and how we strive to identify savings necessary. Much of the theory behind QIPP (Quality, Innovation, Productivity and Prevention) is that we find ways to invest to save – though at times it becomes save to invest where we don’t hit the targets necessary.

This year we have a huge QIPP challenge and at last we have identified some key areas where in theory we can make some large savings in South Manchester without impacting upon patient care: indeed if we get it spot on we will make things better for patients and have money to invest in further improvements.

Analysis shows that if all our South Manchester GP Practices prescribed at the same level as the average practice nationally, we would spend a staggering £6million less per year: that is massive. We of course realise that shift won’t happen overnight, and that our demographics may mean we can’t get to the average, but it does suggest we can make significant in-roads and save money.  We can save large amounts if our practices prescribed at the Greater Manchester average, and in some cases if they prescribed at the South Manchester average!

To be honest, when this was presented to the Public Patient Advisory Group (PPAG) it didn’t take each member very long to come up with a story about how they had seen waste in the not too distant past, and when you start thinking of services that could be put in: advice services that may help prevent depression and reduce the use of anti-depressants, faster access to physio that could prevent long term use of pain killers, medicine management staff who can review the efficacy of some of the repeat prescriptions; it doesn’t take long to realise we can invest to save quickly.

So this month we have started a process where we can look at investment in our primary care (by which we mean GP Practices) that can help get prescription costs down.  Practices will be offered an investment on the basis they can deliver the savings.  We are looking for them to innovate, to use their knowledge of their patients to maximise the impact of their investment.

PPAG were keen to ensure that practices talk to their patients groups (unfortunately innovative in some areas!) about what the best approach might be and to encourage a dialogue locally with individual patients about making the prescribing more efficient.  We need to act quick but some broader involvement in the investment could help us maximise the savings: then we can make further investments.  Those who have invested in patient groups in the past and maintained them will be best placed to engage – we need to keep encouraging true local participation groups that engage clinicians in dialogue with patients.

The process will have to be quick – we need to realise the savings now – but the potential is huge, if we get our investment in primary care right and if we seek to co-design with our communities and keep the focus on the patients we may just have the right prescription for South Manchester.

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