Journey of a Prescription – Waterloo House Surgery, by Ben Merriman, Practice Pharmacist
This article was first published in 2020, however, given the number of queries we receive in relation to prescriptions, we thought it would be helpful to re-issue it
Many people will take prescribed medicines regularly. These are often referred to as “repeat prescriptions” because, as the name suggests, they are continuations of medicines already prescribed. They are commonly used for treating many long terms conditions including high blood pressure and asthma.
If you have a stable, long term condition such as high blood pressure, a condition that once under control doesn’t fluctuate much and therefore doesn’t require regular changes in medicine or dosage, it’s not an efficient use of anyone’s time to have to see a GP every month or two solely to get a supply of medicine. As such, surgeries set up “repeat prescriptions” to allow GPs to see patients needing their expertise and to make things easier for patients.
However, just because the condition is stable does not mean that things cannot change and just because the medicine doesn’t cause problems now, doesn’t mean they can’t cause problems in the future. As such, there are a number of safeguards in place to ensure that medicines are prescribed safely and appropriately. After all, issuing a prescription isn’t as simple as putting your signature on a piece of paper or clicking a mouse button….
When the surgery receives a prescription, the reception team will process the request by selecting the medicine from the patient’s regular prescription list and check that it’s not being ordered too early. If a medicine is ordered too early, it can often indicate that a patient’s treatment isn’t working or that they don’t understand how to take the medication correctly. They will also look at requests for medication that haven’t been authorised for long term use, e.g. pain killers, and send them to the clinician that started the medicine to allow them to assess whether a repeat prescription is appropriate or whether the patient needs to be reviewed.
The completed request is then sent to a clinician for further checks. The patient’s most recent blood tests will be checked, both to ensure that they’re up to date and that the drug is having no adverse effects. The medicine will also be checked that it is compatible with the other medications that are taken. These jobs are vital to ensure that the medicines are used safely and need to be done manually. Computers have made things an awful lot safer and can indicate when there may be problems but it takes years of training and experience to make a decision as to the appropriateness of a medicine for a patient.
At Waterloo House Surgery, we process repeat prescriptions for around 1,000 medicines each and every working day. That’s around 1,000 checks for liver and kidney function, around 1,000 checks for adverse effects and around 1,000 checks for possible interactions. Of course, all these checks take time and it for this reason that the surgery ask for two working days between receiving your prescription request and the prescription being sent to the pharmacy. You will also need to allow time for the pharmacy to process the prescription.
To help try to make things easier for patients, we’re implementing a couple of new methods for getting hold of medicines. Firstly, we now use the Patient Access mobile phone app, allowing you to order repeat prescriptions from your phone 24 hours a day, seven days a week. Each individual patient needs to have the app configured on their phone – a member of the reception team can help you with this.
We are continuing to roll out the NHS Repeat Dispensing system. This allows the surgery to issue a batch of prescriptions to last for up to a year. It’s an easy and convenient way of getting your regular medicines and makes the prescription process smoother for both the surgery and your pharmacy too. It’s not suitable for all medicines as some medicines will require close monitoring (e.g. drugs for arthritis or inflammatory bowel disease) and strong painkillers such as morphine or tramadol. If you have any questions about this service, please ask either at the surgery or your community pharmacy.