Repeat Prescription Policy & Code of Practice

 

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Introduction

A repeat prescription is a prescription that is issued with prior arrangement with the doctor so that you don’t need to be seen in surgery on every occasion that you require a prescription.

It is important that the issuing of repeat prescriptions is carefully managed by the practice for the following reasons:-

  • to ensure that patients receive the correct medication in a timely manner
  • only medication that is required is ordered, thus not leading to stockpiling
  • requests are reviewed and approved by the prescriptions team and prescribers within the practice for safety and quality

This patient policy should also be read in conjunction with the Repeat Prescription Management: Code of Practice and the DMARD Code of Practice.

 

Applicability

This policy is applicable to all patients registered with the Practice.

 

Process

Requests for repeat prescriptions must be received from the patient, parent (if under 18 in most cases) their carer or care home staff. It is Practice Policy not to accept third party requests from community pharmacists or appliance suppliers. The practice should be confident that the person making the request has the patient’s permission to do so.

Requests can be made via

  1. Patient Access request (Preferred Choice) 
  2. The Prescription voice mail request (24 hours a day)
  3. Completing the white slip of paper returned from the chemist and clearly indicating which items are required (please tick each item and cross out any unrequired items)  and return to the box provide in the surgery 72 hours are required in order to make  the prescription available (excluding weekends and bank holidays).

All required medication must be listed by name as “all repeats” cannot be accepted for safety and good practice and in order to avoid waste.

Every time you order a repeat prescription you will be asked to nominate your chosen pharmacy, this is to ensure your prescription goes to the correct destination.

 

28 Day Prescriptions

The surgery’s Practice Policy is to for 28 days supplies of medication. This means that you will be supplied with repeat medication on a monthly basis. Please remember to re-order your medication in good time and to ensure that you don’t run out of anything. In the event of this happening please contact the Reception team rather than your doctor.

 

Generic Prescribing

This practice has an agreed policy to prescribe generically wherever possible for safety and cost effectiveness unless there is an agreement with your doctor that a branded medication is required. Some medication must be prescribed by brand such as medication for epilepsy.

 

Early Requests For Holiday

Please state on your prescription request if you require a prescription to be issued before it would usually be issued for example, if you are going on holiday. Requests for medication that not due to be issued will be followed up by the Prescription Team.

 

Prescriptions For Extended Holidays

The surgery usually will be able to issue three month’s supply of medication on request if you are going on an extended holiday/moving abroad. Thereafter you will be required to register with a medical centre in your place of travel in order to receive a further supply of medication.

 

Forgotten Prescriptions

Should you go away on holiday and forget your prescription please contact your nearest pharmacy and obtain their full postal address and their NHS.net email account. Our preferred method is to securely email to an NHS email address rather than fax the prescription. You will then need to contact our reception team with the details of what you
require and the pharmacy details. 

We will endeavor to get your prescription signed by a doctor and sent to the pharmacy as soon as possible, however please be aware that this may not be on the same day.

 

Repeat Dispensing

Repeat Dispensing allows pharmacists to manage and dispense repeatable NHS prescriptions in instalments in partnership with the patient and the prescriber. This surgery is not currently offering this service.

 

EPS

The surgery is not currently sending prescriptions through the Electronic Prescribing Service (EPS)

 

Medication Reviews

In order to meet the requirements for a Repeat Prescription, you will be required to have a medication review in your birth month. This means that in the month of your birth you will require follow up from the surgery and you will be advised of this via the Prescription Team. This review may involve an appointment with the Health Care Assistant if blood tests or a blood pressure review if required. Once this has been checked you may require a review with a Practice Nurse for a clinic review (such as diabetes or CHD) or a review with your
doctor – in surgery or via a telephone consultation. If you have access to a home blood pressure monitor you may be asked to keep a log of readings over several days and to hand it in at reception. If you are due to run out of medication before your birth month review please contact the Prescription Team who will arrange for a further supply to be issued until your birth month/clinic review. Some medication may require more frequent reviews to the usual birth month review and you will be advised of this by the Prescription Team.

Failure to attend for your annual review may mean that prescriptions can only be issued to you on a weekly basis, you will be notified by letter if this is the case.

Some patients may undertake blood tests at hospitals, however, if we are unable to obtain these results i.e. from a hospital outside of the area, then if we are required to continue to prescribe medication you may be asked to repeat these tests with the practice for safety reasons.

 

Lost Prescriptions

It is the responsibility of the patient to look after all paper prescription and to present it at their choice of community pharmacist for dispensing. You can opt for your choice of community pharmacy to collect your prescription from the surgery and to return it to the chemist for later collection.

You must report details of all “lost” prescriptions to the surgery and you will be advised if you must also report this to the police (in which case please obtain a crime number)

 

Hospital Discharge Medication / Outpatient Letters

Patients who are seen in outpatient clinics may have changes made to their medication. We will update this at the surgery as soon as we can. If you are given a Treatment Advice form from a consultant/clinic which is a request for your doctor to prescribe medication, in most cases this will be processed as soon as possible. If there are any clinical queries or confirmation needed on the request, this process can take up to three working days. This allows us time to discuss with the healthcare professional any queries. Any deviation from the timeframe specified, the prescription team will contact you. Should the consultant wish you to start this medication the same day you will have been given a prescription by the consultant

 

Minor Ailment Scheme

You may be able to access NHS health advice and free treatment without an appointment from your Community Pharmacist for a range of common illness and ailments such as indigestion, hayfever, eye infections, stings and bites and diarrhoea. If you don’t pay for your prescription you can get a wide range of medication without the need to see your doctor.Please ask your Community Pharmacist for more advice.

 

References 

  • Repeat Prescription Management: Code of Practice
  • DMARD Code of Practice
 

Code Of Practice 

Guiding Principles 

  • Patient will make their own repeat medicines request. Deviation from this will require the patient’s informed consent
  • Practice will provide a variety of methods for patients to request repeat medicines
  • Paper-based methods of requesting repeat medicines should utilise the most recent printed repeat prescription request slip (right hand side of FP10 (prescription) form) wherever  possible
  • All parties will communicate regularly and work together to ensure the accuracy of practiceheld records and minimise unnecessary waste of NHS resources  Practice Agreement: 
  • Provide and promote different methods to allow as many patients as possible to request repeat prescriptions themselves, including email / web-based systems
  • Maintain a register of patient who are unable to re-order repeat medication and contact these patients or representatives to enable prescription orders to be placed
  • Keep Patient Medication Records (PMR) current, particularly in respect of the list of authorised repeat medication, and paying particular attention to ‘when required’ medicines
  • Include relevant information of pharmacies authorised to collect repeat prescriptions in PMR for each patient as appropriate
  • Ensure that the patient is made aware of their regular medication review dates, and undertake regular reviews 
  • Routinely provide patients with a single copy of their current printed repeat prescription request slip (right hand side of FP10 form)
  • Respond within 12 hours to communication from patient or pharmacy concerning repeat items e.g. no longer required, excessive quantity, dosage clarification, date ordering 
  • Inform the patient and/or pharmacy of any repeat items that will not be issued 
  • Fulfil repeat prescription requests accurately, avoiding any unintentional additions or omissions, and within 72 hours in accordance with Practice Repeat Prescribing Protocol
  • Refrain from directing patients to a specific pharmacy, including internet pharmacies, which are not of the patient’s choosing
  • Keep records of prescriptions given to pharmacy staff, including drivers, to ensure there is an audit trail. Identification will be asked for to confirm person picking up the prescriptions, which will be in sealed bags 
 

Pharmacy Agreement: 

  • All patients who are capable, to request repeat prescriptions for themselves; notify the practice of patients who may not be in a position to re-order their own medication
  • Keep comprehensive records of all requests, so that there is an audit trail for every prescription from receipt of prescription to prescription delivered (or collected) 
  • On day of dispensing, confirm that every medicine prescribed is required by patient, and notify practice of any ‘Not Dispensed’ medicines, to maintain accuracy of practice records.  (On FP10, annotate as ‘ND’ and strike through item and return Rx to surgery to record to be amended.)
  • Ensure that the patient is made aware of their regular practice medication review dates
  • Where possible, for medicines requiring closer monitoring e.g. warfarin, methotrexate, lithium, record clinical monitoring on your computer records in-line with Patient Safety Good  Practice Recommendations 
  • Pharmacy staff, including drivers, to ensure there is an audit trail will present identification when picking up the prescriptions, which will be in sealed bags from the surgery
  • Upon receipt of the prescriptions any discrepancies are notified to the practice 
 

Patient Agreement: 

  • Be responsible for requesting own repeat prescriptions. Which can take up to 72 hours to process as per the practice policy 
  • When requesting repeat medicines, only to request regular items that will be required within the next 7 days, and ‘when required’ items as needed 
  • Keep the most recent printed repeat prescription request slip and use it to request the next supply as above (unless using email / web-based systems)
  • To discuss with the practice / pharmacy any repeat medicines that they do not want to continue to take, or are stockpiling, to minimise waste
  • Provide confirmation in writing that the pharmacy is authorised to collect repeat prescriptions for them, or to change a pharmacy nomination and to discuss relevant medicines management issues with the practice
  • Inform pharmacy / practice as soon as possible of any changes affecting their regular medicines, to ensure that Patients Record is kept up to date
  • Attend medication reviews and clinical checks at the GP practice when requested