72% of medicines management payers at Primary Care Trusts (PCTs) believe that GP consortia will develop their drug own formularies, a new poll has found.

59% of the PCT payers also believe that consortia will develop their own guidelines, according to the survey, which was conducted by specialist health care publisher MGP.

At 37.4%, the largest percentage of  payers told the survey that they hold “quite negative” feelings about the proposed changes to the structure to the NHS, as outlined in the government White Paper, Equity and Excellence - Liberating the NHS. Only 1% said that they were “extremely positive” about the plans, while 17.2% were “quite positive” and 19.2% were “extremely negative.” 25.3% were neither positive nor negative.

The poll also reveals widespread concern among payers that expertise and jobs will be lost as a result of the reforms. One respondent warned of “huge risk issues around medicines safety,” and added: “formulary management will be difficult.” Another was worried about the potential loss of existing expertise around medicines management and controlled drugs, and for the future of local community pharmacy services.

One respondent wondered whether GPs really appreciate the work medicines management staff do as pharmacists, and asked: “will they pay for our services in medicines management?” The study revealed that this is a matter for concern for a number of respondents; one pointed out that medicines management teams can be “quite large” in some areas, and asked, if they are to be directly employed by GP consortia, whether the consortia could, or would want to, pay for the whole team.

GPs “do not have the skills or time or, in some cases, the aptitude/interest to manage commissioning decisions around medicines,” said another payer. “Local practice-based commissioners have not managed to control the drugs budget to any great extent in the past year, with the outcome that [the] medicines management team are trying to implement major cost-saving exercises," they added.

Many also foresaw a return to post-code prescribing, as a result of funding decisions being made at the local level, and also felt that, with the government’s planned changes to the authority of the National Institute for Health and Clinical Excellence (NICE), that prescribing may become less evidence-based.

One respondent saw a greater role for the pharmaceutical industry within the GP commissioning environment, but warned that this could lead to potential bias and conflicts of interest. While independent medicines advice will cost the consortia, advice from the pharmaceutical industry is free, they said, and asked: “so, which will they choose?”