Patients care ‘is being put at risk’ as a QUARTER of GP surgeries take more than two years to start prescribing new drugs, researchers warn

• Researchers from University of Oxford looked at 8,000 GP surgeries in England 
• Found a quarter took two-and-a-half years to implement new drugs to patients 
• Small number (10%) took more than 32 months before dolling out medications  

Patients’ care is being put at risk because many GP surgeries around the country are playing catch up with prescriptions, experts warn.

British researchers found a quarter of practices took around two-and-a-half years to switch to new treatments.

A small number of surgeries (10 per cent) took 32 months to start prescribing the new drugs.

Experts say the variation is an avoidable waste of NHS money that exposes patients to ‘sub-optimal’ care.

The research team from the University of Oxford looked at more than 8,000 GP surgeries in England.

Patients’ health is being put at risk because a quarter of GP surgeries around the country are playing catch up with prescriptions (file image)

Using the database OpenPrescribing.net, they analysed how the quickly practices responded to two treatment switches over a five-year period.

The first was a shift to the generic female contraceptive pill desogestrel, previously sold under the brand name Cerazette, in 2012. 

The second was to change the first line antibiotic for treating uncomplicated urinary tract infection (UTI) from trimethoprim to nitrofurantoin in 2014.

Considerable variation was found between practices in both the timing and how rapidly change was implemented once it had begun.

While the majority of practices began to shift away by Cerazette by early 2013, a quarter did not show substantial change for 14 months.

HUNDREDS OF VILLAGES LOSE THEIR GP SURGERIES

Hundreds of villages have lost their GP surgeries, according to a national survey.

Coastal and rural areas are suffering the most with elderly and vulnerable patients being forced to travel further for appointments.

Research showed 1,946 villages are now at least three miles from their closest GP practice – 162 more than two years ago.

Some patients were required to travel up to 14 miles in rural areas.

GPs say they are stretched too thinly because of a shortage of 5,000 doctors. 

They also said that younger medics were less likely to want to work in rural areas.

‘Rural, coastal and deprived areas always struggle the most to attract GPs, but with a national shortage, they are being hardest hit,’ said Helen Stokes-Lampard, who is chairman of the Royal College of GPs. 

‘They are the canary in the mine for a problem across the country.’ 

Among the districts hit worst are South Gloucestershire, South Northamptonshire and Cornwall. 

In the past six years almost two million patients have been affected by 585 surgery closures, according to data analysed by Pulse magazine.

A small amount (10 per cent) of practices took at least a further six more months.

The move to desogestrel was projected to save the NHS £10million. But because some practices were so slow to implement the change, the health service was exposed to avoidable costs, the researchers note. 

For antibiotics, a quarter of practices did not make their largest change until 29 months after the guidance was released.

Ten per cent did not change until at least 32 months after the release, subjecting patients to substandard care.

However the academics say the slower implementation could be because the antibiotic guidance was less clear.

The study, published in the British Medical Journal, is an observational one and can’t establish cause. 

But researchers said better analysis techniques to monitor implementation of the drugs and clearer communication with clinicians could solve the issue.

Writing in the study, the academics said: ‘Most practices changed their behaviour but some changed much later than others.

‘And some practices showed rapid, coordinated change, while others changed only gradually. 

‘This heterogeneity [variation] is problematic: it exposes health systems to substantial avoidable costs and exposes patients to suboptimal clinical care. 

‘Although expecting all practices to respond immediately and adopt optimal prescription behaviour might be unrealistic, the fact that some practices changed both early and rapidly suggests that rapid timely change is possible.’ 

Further work is required to explore the reasons for some practices being slow to implement prescribing changes. 

The team added: ‘We have previously written on the importance—and comparative neglect—of systems to disseminate knowledge to clinicians and patients, and social structures to audit and assess the implementation of warranted changes in practice.’

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