General practice fundholding and health care costs

摘要

Fundholding general practices receive budgets to cover three aspects of patient care: ancillary practice staff, a range of non-emergency hospital services, and prescribing. Savings made on these budgets may be moved between the different components or spent on other ways of enhancing services to patients. One of the objectives of introducing fundholding was to give practices a direct incentive to contain the rise in prescribing costs. The study from Northern Ireland published in this week's EMJ (p 166) provides further evidence of limited success in this objective. In their first year of fundholding, practices increased their rate of generic prescribing and reduced the rate of rise in their prescribing costs. After the first year of fundholding, first wave fundholders' prescribing costs increased at the same rate as non-fundholders' costs.