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Prescription for an electronic revolution?

December 18, 2007

Patients could be saved millions of trips to their GP under a new scheme that has the potential to revolutionise the system of prescribing medicines.

The electronic transfer of repeat prescriptions between general practices and pharmacies is currently being rolled out across the UK, in a bid to streamline the system and make it faster and more convenient for patients - as well as cutting down on prescription errors.

And now the scheme is to be studied by academics at The University of Nottingham after they were awarded a £750,000 research grant from NHS Connecting for Health. A team of experts will spend two years analysing whether the system, which had its official launch on October 1, 2007, will benefit patients and the NHS. Professor Tony Avery, of Nottingham University Medical School, will build on his proven track record of research expertise in the field of prescribing in primary care.

Changes to the current system will affect huge numbers of people, because repeat prescriptions account for more than 70 per cent of all prescriptions made on the NHS - around 500 million items of medicine every year.

Many are for elderly patients being treated for long-term ongoing conditions such as high blood pressure, asthma, arthritis, musculo-skeletal conditions and diabetes.

At the moment, a patient with a repeat prescription is required to go back to their GP practice each time their medication runs out, to request another prescription. The GP processes and signs each request by hand, meaning a wait for the patient of 2-3 working days. The patient then returns to the GP to pick up the new prescription, and then makes another journey, this time to the pharmacy to get their medication.

Under the new system, repeat prescription orders will be transferred electronically direct from the GP to the pharmacist when the previous prescription expires. So the patient need only make a single trip to the pharmacy, where their barcoded prescription form is swiped under an electronic reader and the medicine handed over.

Apart from the savings on the number of journeys patients have to make to get their prescription, the new system should also cut down on the number of errors that can occur when details are copied across from one form to another. It should also speed up payment for the GP, by transferring payment requests electronically to the Prescription Pricing Authority in Newcastle. Currently these requests are sent in hard copy, by post.

Tony Avery, Professor of Primary Care in The University of Nottingham's Medical School, said: "The current system does work. But if you look at it in detail, the inevitable conclusion is that there must be a better way, a more efficient way, of issuing repeat prescriptions.

"The new system could radically alter the way in which we handle repeat prescriptions for patients on long-term medication.

"In many cases, patients who are on long-term medication don't need to be routinely seen when their prescription is re-issued. These patients - many of whom are elderly - would benefit considerably from a system which makes it easier for them to get the medicines they need.

"There is also a major impact on GP practices in terms of reducing the paper workload and making things more efficient."

The study will build on Professor Avery's work in the field of patient safety, and will incorporate a large-scale before-and-after study to determine whether the new system results in a reduction in dispensing errors.

Professor Avery will be working alongside colleagues at The University of Nottingham including Dr Sarah Armstrong in Nottingham University Medical School, Professor Rachel Elliott in the School of Pharmacy and Dr Justin Waring in the School of Sociology.

On average there are 14 prescriptions dispensed per year to each person in the UK. But this is heavily weighted towards pensioners - with over-65s receiving an average of 38 prescription items each per year. The majority of these are for long-term conditions.

The cost of prescriptions in England amounts to around £8bn a year.

The funding for the study comes from the National Health Service's Connecting for Health programme. It is being carried out in collaboration with the London School of Economics and the University of London School of Pharmacy.

The University of Nottingham