NHS England updates guidance on prescribing between primary and secondary care

A working group chaired by Keith Ridge has updated NHS England guidance on medicines optimisation, saying that pharmacists have a vital role to play.

Keith Ridge, chief pharmaceutical officer for England

The contribution that prescribing pharmacists who work in general practice can make to boosting GP and patient understanding of medicines has been highlighted in guidance published by NHS England.

Published on 13 March 2018, the document says that pharmacists are perfectly placed to support GPs who may be unfamiliar with drugs originally prescribed to their patients in hospital, and have a vital role in building stronger links between primary and secondary care around optimisation of medicines and medicines management.

‘Responsibility for prescribing between primary and secondary/tertiary care’, which applies in England, has been updated to reflect the changes in medicines management and the shift towards achieving medicines optimisation that have occurred since it was originally published in 1991.

“Clinical pharmacists in general practice are experts in optimal medicines use, monitoring, and review; and so will provide good support to all general practice staff,” the guidance says. “They are a good point of contact for hospitals for all medicines-related matters, including when designing and implementing shared care arrangements.

“Clinical commissioning group medicines optimisation teams, working with clinical pharmacists in GP practices, can support joint working and collaboration with hospital chief pharmacists to ensure that GPs and other primary care prescribers have access to information on new or less familiar medicines, and the related prescribing policies.”

The guidance reiterates the advantages of the electronic prescription service in hospitals which it says should be used to “encourage efficient provision of prescriptions form secondary care when required”.

The guidance spells out the number of days a prescription should cover when a patient is either discharged from hospital into the community after being an inpatient, has been seen in an outpatient clinic, or has attended a hospital emergency department. In general, it says the prescription should provide seven days’ supply of drugs.

The guidance has been developed by a working group chaired by Keith Ridge, the chief pharmaceutical officer for England, and its aim “is not intended to undo or undermine existing prescribing arrangements that have been deemed to be working well across health communities by primary and secondary care, but it does aim to reduce the level of variation and to improve the quality of patient care”, it says.

Last updated
The Pharmaceutical Journal, PJ, April 2018, Vol 300, No 7912;300(7912):DOI:10.1211/PJ.2018.20204548

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