The new guidance published on management of repeat medication requests by the Pharmaceutical Services Negotiating Committee, which negotiates the community pharmacy contract in England, and Pharmacy Voice, the trade association of community pharmacies in England, offers a plausible solution to unused medicines returned to pharmacies for disposal. Recently, I received a large amount of unwanted medicines that were returned to the pharmacy, which took around 30 minutes to dispose. This is costly to the NHS and impacts on time management of staff.
The new guidance reviews current systems and practices on how pharmacies manage non-NHS patients repeat requests. It demonstrates that pharmacies have clinical and operational processes in place, which are underpinned by standard operating procedures to support safe and effective medicines ordering requests. It also highlights that pharmacies need to help local GP practices understand these operational processes in order to avoid clinical negligence owing to untimely delays to patients’ access to their long-term medicines.
Identification of GP practices underusing the NHS Repeat Dispensing (RD) and electronic Repeat Dispensing (eRD) systems reflects the need for training for GPs and their staff and the pharmacy team to use and promote the benefits of this system, which enhance patient safety and minimise waste. According to the guidance, only 8% of NHS prescription items were dispensed using the RD service in England. In addition to improve the uiltisation of the NHS RD system, the guidance advocates a collaborative approach with local medical and pharmaceutical committees, local health watch and patient organisations.
A joint working relationship between GPs and pharmacies is even more necessary, based on the existing notion of poor information sharing. For instance, annual reviews between GPs and patients, as well as medicines use review by pharmacists, should be used as platforms to share information on effective management of medicines requests. GPs could amend patients’ repeat list so that only long-term medicines are listed on patients’ repeats, this will minimise requesting unnecessary items. Similarly, pharmacists should use patients’ medical record effectively to check medication frequencies and potential wastage. The new guidance provides a comprehensive and analytical approach, in comparison to both Luton and Coventry Models ran by patients and clinical commissioning groups, respectively.