GPs in Wales have been asked to extend repeat prescription intervals from 28 days to 56 days, as part of reforms aimed at freeing up community pharmacists’ time.
The change, set out in guidance published jointly by Community Pharmacy Wales (CPW) and the British Medical Association’s General Practitioners Committee (GPC) Wales, will take place from April 2022, with all patients changed either at their annual medication review or over a two-month timeframe.
The guidance notes that some patients should be excluded from this change, including those taking schedule 2, 3 or 4 controlled drugs and patients who need more frequent monitoring.
It explains that reducing the dispensing volume “is an enabler to release capacity within community pharmacies”, freeing up time to deliver “more clinical services”.
In December 2021, the Welsh government announced plans for pharmacies to offer a range of services under a new ‘national clinical community pharmacy service’ from April 2022, which will combine an emergency contraception service, common minor ailment treatment service, emergency medicine supply service and annual flu vaccination service.
The guidance on dispensing intervals adds that community pharmacies should work with their local GP practices to discuss and agree a proposed plan for switching patients onto the extended prescription interval.
The change in interval follows a government-commissioned review of dispensing volumes in community pharmacies, published in March 2021, which found that “extending prescribing intervals is universally seen as a real opportunity to save the workload of community pharmacists on repeat scripts”.
However, it said that Wales lagged behind other UK nations, providing data showing that fewer than 10% of prescriptions were issued for longer than 30 days in Wales. This was compared to more than 40% in Scotland and Northern Ireland and around 25% in England.
The Welsh government responded to the review in January 2022, saying that GPs and pharmacies in Wales “have to write and dispense more prescriptions than in other parts of the UK”, and that “where clinically appropriate, more patients should be able to have their prescribed medicines dispensed less frequently”.
It is important to “ensure that the unique skills of pharmacists and pharmacy technicians are utilised in supply chains only where they add value, and unnecessary dispensing transactions are minimised,” it said.
The government’s response added that local health boards in Wales are expected to have plans in place to support the implementation of extended prescribing intervals by March 2022.
Cheryl Way, chair of the Royal Pharmaceutical Society’s (RPS’s) Welsh Pharmacy Board, said changes to prescribing intervals for suitable patients was “welcome”, but added that “it is paramount that any changes must be made alongside the patient, with safety at the centre”.
“Together with the proposed changes to reduce the dispensing of non-medicinal products and low-value items, we hope that these changes will reduce pressures on community pharmacy teams and will build more capacity to focus on the clinical elements of the new community pharmacy contract,” she said.
“It is important that community pharmacy teams and prescribers work together so that the changes are rolled out in a consistent and patient-centred way across Wales.”
A spokesperson for CPW said previous guidance “to generally prescribe in 28 day intervals was issued some years ago in response to suggestions that extended periods of treatment resulted in more medicines being wasted”.
“However, we have seen no evidence to support this claim,” they said.