Centralised prescriptions across GP practices in North Somerset pilot

Identify and understand

A pilot scheme by Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG ICB) to centralise repeat prescriptions across GP practices has saved the NHS more than £187,000 and been shortlisted for a national award.

The Centralised Repeat Prescription Hub was set up for 16 months to serve patients registered at the Tyntesfield Medical Group in North Somerset.

Key stakeholders were identified as GP teams, who were involved in development of the hub, and patients are care homes, who were kept informed via pharmacies, posters and leaflets.

The pilot was undertaken with the aim of reducing demands on GP workload and reducing unnecessary prescriptions items being issued which can lead to stockpiling and waste. The broader aim was to ensure good medicine optimisation, improve quality and safety and reduce drug spend.

See more about step 1 in the evaluation cycle: Identify and understand

Assess

The pilot was in-keeping with BNSSG ICB’s key priority to make sure medicines are prescribed efficiently, including reducing over prescribing and medicine waste.

It was identified that the evaluation and improvement of the service would not be categorised as research.

See more about step 2 in the evaluation cycle: Assess

Plan

The aims of the evaluation of the pilot were:

• To assess whether investment in the repeat prescription process could reduce growth and overall ordering/issuing of unnecessary prescription items that lead to stockpiling and medicines being wasted, thereby ensuring good medicine optimisation, improving quality and safety and reducing drug spend
• To review the practice benefits this process could offer including any reduced demands on GP workload

See more about step 3 in the evaluation cycle: Plan

Do

The pilot saw all repeat prescriptions, sent from the four practices, electronically to a dedicated team of trained clerks at the hub, which was based at the Brockway practice. Prescriptions would usually be processed by individual practices. During the pilot, which took place from September 2017 to October 2018, more than 7,700 prescriptions were rejected which was attributed to hub staff being more vigilant in analysing prescription requests. The rejection rate dropped after the pilot had ended suggesting patient behaviour change following advice on correct ways to order prescriptions.

See more about step 4 in the evaluation cycle: Do

Review and act

Results showed that patient safety increased due to more vigilant checks and led to costs savings of £187,640 due to a reduction in over prescribing and medicine waste. The scheme also freed up time for GPs and other practice staff who reported saving on average an hour a day.

BNSSG ICB is now recommending that the model is rolled out across the area.

See more about step 5 in the evaluation cycle: Review and act