Embedding the RCGP/RPS Repeat Prescribing Toolkit into Primary Care Practice

Suffolk and North East Essex ICB, Medicines Optimisation Team

Project summary

Whilst developing a systemwide campaign to reduce avoidable medicines waste, it became clear that a structured audit of the whole repeat prescribing process across all primary care partners would be extremely valuable. Engagement with patient groups highlighted the complexity of the problem and the RCGP/RPS Repeat Prescribing Toolkit was identified as a nationally agreed framework that could be used by both GP practice teams and community pharmacies. This ensured that we could look at repeat prescribing as a whole process, focussing on areas where we could safeguard against waste at every stage, rather than just at the patient level.

The Suffolk and North East Essex ICB Best Value Medicines team worked with the representative organisations for both GPs and community pharmacy contractors and the ICB Community Pharmacy Clinical Lead, to agree the initiative.

Practices were asked to review their repeat prescribing processes using the questions listed under the five toolkit domains (organisational culture, clinical responsibilities, technical, administrative and patients). They were then asked to submit five priority actions via MS Forms based on the specific process within their practice. Funding was offered to each practice to support this work, and this was built into a local scheme that rewards appropriate prescribing. A further payment to practices was offered if they submitted an update after 6 months on what had been achieved against the original actions.

All the original documents from the toolkit were used and were offered in electronic format for ease of completion and review. The medicines optimisation team reviewed each submission, identifying common issues for both local and system resolution.

Community pharmacies were asked to engage with the initiative by completing the 10 community pharmacy questions within the toolkit, via a further MS Form. They were asked to engage with any GP practices that approached them as part of their review. Funding was made available to any community pharmacy that engaged with the initiative.

82 out of 90 GP practices (91%) submitted an initial action plan identifying five actions that each were priorities for them. 74 of the initial 82 practices (91%) submitted an update to that action plan after 6 months (one practice had merged)

83 out of 162 community pharmacies (51%) answered and submitted the toolkit questions.

key integration issues were identified, and a newsletter was sent to all practices and pharmacies highlighting the topics that arose most commonly along with national resources and suggestions for local actions to support patient care.