Consultation response: Review of the Northern Ireland General Practice Prescribing Formula 2024/25

Overview

Expenditure on General Practice prescribing covers the costs incurred by General Practices in prescribing medication, which is subsequently dispensed in the community to their patients.  In Northern Ireland, in 2023/24 there were over 45m items dispensed in the community, with an ingredient cost of over £501.3m.

The mechanism for allocation is a weighted capitation formula.  The concept is such that resources are distributed based on the needs of the population, rather than on a purely per capita basis.  Needs arise from (i) age & gender, (ii) higher prescribing needs for those in care homes and (iii) additional need arising from socio-economic factors, morbidity and deprivation.

The weighted capitation formula is used to set annual indicative prescribing amounts (IPAs) for Local Commissioning Groups, GP Federations and General Practices.  It is vital that these IPAs are accurate as out-turn against allocation is continuously monitored to assess the performance of General Practices, GP Federations and LCGs in effective prescribing.  The overall NI budget for General Practice prescribing is the responsibility of the Strategic Planning & Performance Group (SPPG), Department of Health (DoH).

The concept of a weighted capitation formula to allocate General Practice prescribing allocations was first introduced in Northern Ireland in 1998/99; the formula has since undergone a number of reviews, and the current formula has been in operation from 2016/17.  It is good practice to regularly review such formulae to ensure they reflect current need; this was the opportune time given release of Census 2021 data which is vital in analysis and development of the formula.

Extensive analytical work has been undertaken in-house by statisticians within the Department to develop updated components of the weighted capitation formula.  All research and analysis have been subjected to external scrutiny by an independent peer reviewer; after this scrutiny the formula was endorsed and declared fit for purpose.

The Review has now set out conclusions regarding development of each component of the formula, robustness of the formula application at LCG and General Practice level and testing at small area in terms of targeting deprivation. Each component of the new formula has also been tested against NI equality legislation and analysis demonstrated that the new formula would not create any adverse impacts on any of the equality categories.

It is recommended that the weighted capitation formula should continue to be used to allocate prescribing resources to LCGs and should be used as an indicative tool in subsequently informing allocations to General Practices and GP Federations.  With this aim, the Review has set out key recommendations with regard to updating the formula and is now seeking feedback on these proposals.

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Why your views matter

Your thoughts and feedback on the recommendations of this review are very important.  Your views can be submitted by completing the online survey.  However, if you wish to send an email or hard copy you should complete the consultation response document and submit your response using the correspondence details below.