Statement on the NHS North West London CCG Collaborative’s “Choosing Wisely” changes to GP prescribing


Healthwatch Hillingdon’s statement on the NHS North West London CCG Collaborative’s “Choosing Wisely” changes to GP prescribing (16/06/2017):

“Healthwatch Hillingdon has been extensively consulted on the NHS North West London (NWL) CCG Collaborative’s proposed changes to GP prescribing. We acknowledge and welcome that significant progress has been made by the NHS with regards to this proposal from its original version and that many of our comments (Our letter to NHS Hillingdon CCG; and the NHS CCG’s response letter) have been reflected in the current proposal. We urge all members of the public to share their views on these proposals in the short 3 weeks allowed, which is a disappointingly short time to comment on a significant change to GP prescribing.

“Additionally, we have asked that the NHS NWL CCGs fully includes the views of the public in how this proposal is applied. It is important to highlight that those people legally entitled to free NHS prescriptions (pregnant women, children and other groups of people as exempted by Parliament) will still be able to get those items that their GP has recommended for their condition free on the NHS if they choose not to buy them from a pharmacy.

“We agree it is right that patients should only be prescribed items which are appropriate to their clinical needs. We would support efforts to ensure that GPs, pharmacists and the public are made more aware of, and are mindful of, the need to better manage limited NHS resources. Healthwatch Hillingdon fully appreciates the financial challenges across NWL CCGs but we question whether the proposal, even in its current form, is the best way to achieve the desired savings. Healthwatch Hillingdon’s own analysis of this proposal shows a maximum saving of £2-3 million at best. We wonder whether a more cost-effective approach could be to provide further enhanced training and support for GPs to improve appropriate clinical prescribing and a reduction in medicine wastage through a NWL public awareness campaign.

“Additionally, we do not think that the current proposal has given sufficient thought to the overall impact on the NHS. Reduced GP access to some of the items proposed in this local list may result in an increase in GP appointments and costly hospital admissions. However, patients have told us that there does need to be some changes to the way automatic repeat prescriptions are ordered which can result in excessive wastage of medicines/items. Therefore, we do welcome some of the proposed changes. Healthwatch Hillingdon will work closely with the NHS NWL CCGs to carefully ensure that vulnerable people and other identified groups are still able to easily re-order repeat prescriptions that their GP has recommended without over-burdening primary care.”

“We, and members of the public will rightly wonder whether this initial list of items is just the beginning of a bigger drive to ration NHS services to meet a challenging NHS deficit of £135 million across North West London. The NHS drive to close this deficit may mean that soon many other medicines and local services could be added to this growing list. Additionally, we remain concerned that in many parts of London and the rest of England, different NHS CCGs are developing similar GP prescribing changes and that there is significant variation in what items are on these different lists. This will without doubt lead to considerable public confusion as to what items they could buy from pharmacies and which items/medicines will be available on the NHS. However, this goes further than “local decision making”, and we wonder whether some of these “difficult decisions” should and must be made at the national level. We therefore call on the national leaders of the NHS and politicians to take responsibility for these difficult decisions and provide clear national leadership and direction. There are difficult decisions ahead for the NHS and difficult choices that national leaders must confront, but this must not happen in a piecemeal and unfair manner.”

For more information contact: Graham Hawkes, Chief Executive Officer

T: 01895 272997 E:


Editors Notes:

About Healthwatch Hillingdon:

Healthwatch Hillingdon is the independent people’s champion for health and social care in the London Borough of Hillingdon. The organisation will help to shape and improve local health and social care in our community.  Healthwatch Hillingdon is part of the Healthwatch national network, established by the Government to ensure local patients and users have a greater input to shaping local services.

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