New national guidance on repeat prescribing has been published in a bid to improve consistency and patient safety – and supporting hospital discharge with digital solutions and optimising use of the Discharge Medicines Service (DMS) forms a key part of this.
The Royal Pharmaceutical Society (RPS) and the Royal College of GPs (RCGP) has launched a new Repeat Prescribing Toolkit, in what is believed to be the first guidance of its kind for 20 years.
The 92-page toolkit commissioned by NHS England after the 2021 National Overprescribing Review, which recognised the impact that poorly operated repeat prescribing can have on overprescribing and problematic polypharmacy.
It encourages GP practices, primary care networks and community pharmacies to work together to understand their repeat prescribing processes through a self-assessment exercise and sets out how teams could map out their repeat prescribing processes and make changes to improve efficiency for healthcare teams as well as patient safety.
This includes encouraging NHS England ‘to expedite digital solutions to allow hospital discharge information relating to medicines to link into the patient record’. This would create a digital audit trail of medication changes made in secondary care to ease the transition to primary and community care services, it said.
Optimising use of the DMS is also outlined as a priority as it ‘has been shown to reduce readmission rates at 30-, 60- and 90-days’ post-discharge.
As such, ‘trusts and community pharmacies should make the most of the DMS to reduce avoidable harm’, the guidance stated.
‘Secondary care and specialist services are asked to make very clear to primary care on discharge of a patient from hospital, the reasons for medicines to be prescribed on repeat, the indication and the intended duration of therapy. Any medicines stopped need to also be clearly documented with a reason for the cessation of therapy,’ it added.
Wider suggestions outlined in the toolkit to improve repeat prescribing in the future include greater functionality on GP and pharmacy systems to recognise the oversupply and over ordering of repeat medication, particularly for higher-risk medicines; modernising electronic repeat dispensing systems to resolve well-known challenges; and raising public awareness of medication safety, medicines waste and the environmental impact of medicines.
Commenting on the toolkit, Clare Howard, RPS fellow and clinical lead author said it represented ‘a significant step forward in ensuring the safety and efficiency of repeat prescribing systems, ultimately benefiting patients and the NHS as a whole’.
Professor Tony Avery, national clinical director for prescribing at NHS England, thanked the RPS and RCGP ‘for their excellent work in producing this toolkit’.
‘I feel certain that it will prove a useful resource for general practices and community pharmacies and will benefit patients,’ he said.
‘With over one billion prescriptions dispensed annually in England, over three quarters of which are repeat prescriptions, it is essential that repeat prescribing systems in general practices are safe for patients and efficient for all involved.’
