UK Fundholding Savings Doubts

While fundholding general practices in Northern Ireland containedprescribing costs more effectively in their first year than non-fundholders, partly by increasing generic prescribing, these savings declined over time, according to a study in the British Medical Journal (July 19).

By the third year, the earliest group of fundholders showed a yearly percentage increase in prescribing costs that was virtually the same as that for non-fundholders. The study authors, Therese Rafferty of the University of Belfast et al, say this finding may suggest "that the incentive for making further savings has diminished after the first two years of fundholding."

The reason, they say, is that fundholders' budgets are reset each year to reflect not only savings but also pay and price rises. Savings are deducted from the reset, which "makes it increasingly difficult to make further changes each year, and may also reduce the incentive to so do."