Repeat prescribing is a common activity in general practice and typically involves all members of the practice team at various stages. It is also a common source of medico-legal complaint. It is now considered best practice that all practices have a formal policy on repeat prescribing and this should be communicated by the GP Principal or his / her named deputy, to all members of the practice team who are involved in repeat prescribing, including locums. Information on the policy should also be made available to patients of the practice and other key stakeholders, when requested. While we recognise that such policies can be complex, especially in practices with larger teams and more sophisticated ways in which patients can interact with the practice, this brief guide is intended as an introduction to the issues which Medisec members might consider in the development and implementation of a ‘Practice Policy on Repeat Prescribing’.
Requests for repeat prescriptions should be made by the patient or his / her carer / representative While we recognise that such requests are most typically made by telephone, many mechanisms of communication are received. Irrespective of the mode of communication, we recommend that the practice receive adequate information to minimise prescribing errors (see Table 1).
Table 1. Information required by practice when managing requests for repeat prescriptions
Upon receipt of a request, the patient or his / her representative should be advised that it will take at least two working days to process requests for a repeat prescription. All relevant information should be available by word of mouth, practice leaflet, repeat prescribing leaflet or practice website.
While we recognise that non-medical members of the practice team may generate a repeat prescription, as the GP principal is responsible for any issues arising from the prescription itself, we recommend that s/he ensure all staff involved in the repeat prescribing process are adequately trained in this regard.
While the prescription is being generated, a number of checks should be carried out, which might include:
When writing / printing and signing a prescription, the doctor should ensure that the prescription is legible, dated, signed and includes the IMC registration number.
Prior to signing, the GP should also carry out a number of checks, which include:
All patients receiving long term medicines through the repeat prescribing system need to be reviewed regularly. The interval should be determined by the GP / practice and will vary on a case by case basis. The review can involve either
This review might involve:
The practice policy on repeat prescribing should include a method for incident reporting and recording and be subject to regular audit and quality review.
Such problems account for 18% of requests for advice / assistance which Medisec receives and these are detailed in Table 2.
Table 2. Repeat prescribing related issues commonly reported by Medisec members.