Healthcare Commissioning Forum

How to reduce medicines wastage and improve the quality of repeat prescriptions by enabling pharmacist to manage repeat prescriptions?

To reduce medicines wastage and improve the quality of repeat prescriptions by enabling GP practices to buy-in pharmacist time to manage repeat prescriptions.

Walsall Clinical Commissioning Group (CCG) implemented a pharmacist-led repeat prescription management service (RPMS).

The service was aimed at reducing medicines wastage, minimising possible harm from medicines and improving the quality of repeat prescribing. Cash was saved by ensuring the least expensive, clinically appropriate medicines were prescribed, for example by switching from branded to generic drugs. Practice-based pharmacists worked as an integral part of primary care general practice teams to manage repeat prescriptions.

The previous system, common in many general practices, involved administrative staff generating the repeat prescription for authorisation by the GP(s) on duty. On average, each GP authorised approximately 200 repeat prescriptions per week.

Under the new system pharmacists generate the repeat prescriptions, authorising those within their medical competence, with the remainder being authorised by GPs.

The role of the pharmacist is to:
-   Produce and sign (if qualified) any relevant prescriptions. Pharmacists are responsible for determining their competencies according to their training and specialisms and must be insured appropriately.
-   Produce a prescription for signing by a GP
-   Change the prescription to a more appropriate alternative that meets the prescribing indicator objectives.

The service allows pharmacists to elicit any relevant information from the patient and the GP system for the purposes of assessing the appropriateness of a request. This information includes medical notes and history, monitoring arrangements and details of other medicines currently prescribed. This helps with:

-   Waste reduction
-   Improving performance against local and national prescribing indicators
-   Optimising treatment regimen
-   Reducing health inequality
-   Enhancing medicine safety.

The RPMS is now established in 56 out of 62 practices.

For further information on the topic please go to : https://www.nice.org.uk/Media/.../14-0001-qp-pharmacist-led-rpms.pdf