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Millions of patients receive their medicines through repeat prescriptions, but there have been cases where people have been put at risk by inadequate monitoring or review of these prescriptions.
Concerns about the lack of regular reviews for some users of long-term medicines were highlighted in the Department of Health and Social Care (DHSC) National Overprescribing Review in 2021. As a result, the DHSC set out a series of practical and cultural changes intended to make sure that patients receive the most appropriate treatment for their needs.
In response, NHS England commissioned the Royal Pharmaceutical Society (RPS) and the Royal College of General Practitioners (RCGP) in 2023 to develop a repeat prescribing toolkit to support primary care in enhancing the safety, efficiency and consistency of repeat prescribing systems across England.
The collaboration involved a diverse group, including GPs, practice pharmacists, practice managers, reception staff, community pharmacists, pharmacy technicians and patients, and the resulting toolkit was launched in October last year. This was the first national good practice guidance on repeat prescribing to be issued in 20 years.
Good practice guide
Repeat prescribing systems vary. In many areas, primary care networks (PCNs) have streamlined systems across several GP practices, but this is not universal. The new toolkit refers to general practice and/or PCNs, setting out what should be included within a good repeat prescribing system.
Acute medicines and appliances are not included within its scope, nor is it a clinical or prescribing guideline, although some higher-risk clinical scenarios are identified. The toolkit includes:
- Self-assessment framework: a structured approach for evaluating current practices against established standards
- Practical guidance: recommendations on improving communication with patients regarding repeat prescriptions
- Resources: case studies, flow charts, action plan templates and other tools designed to facilitate implementation.
Implications for pharmacy
As community pharmacists play a pivotal role in the repeat prescribing process, the toolkit encourages:
- Collaboration: working closely with GP practices to streamline repeat prescribing systems
- Patient engagement: enhancing communication with patients to ensure they understand their repeat prescriptions and the importance of medication adherence
- Safety monitoring: identifying and reporting potential medication-related issues to improve patient safety.
In a joint statement, Tase Oputu, chair of the RPS English Pharmacy Board and Dr Michael Mulholland, honorary secretary of the RCGP, said the two organisations “encourage all GP practices to work together with their local community
pharmacies and to consider if their repeat prescribing systems can be improved in terms of efficiency, safety and patient care”.
They added that the toolkit provides “a framework to achieve those changes”.
Benefits for patients
Implementing the toolkit’s recommendations is expected to improve patient care by ensuring that repeat prescriptions are accurate, timely and appropriate. It should also reduce medication waste by aligning prescriptions with actual patient needs, and enhance safety by identifying and addressing potential medication-related problems promptly.
Future recommendations
Looking ahead, the toolkit suggests strategies to further enhance repeat prescribing. These include:
- Digital integration: implementing digital systems to facilitate seamless communication between GP practices, community pharmacies and patients
- Regular reviews: conducting periodic reviews of repeat prescribing processes to identify areas for improvement
- Patient education: providing patients with clear information about their medications and the importance of adherence.
By advocating these strategies, the toolkit aims to support a move towards a more patient-centred approach, ensuring that repeat prescribing is both safe and effective.
Download the Toolkit here.
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