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DH to launch crackdown on prescribing errors

GP prescribing could come under scrutiny as part of a Government drive to cut medication errors.

The Department of Health said the scheme was likely to be launched early next year, at the latest, and that it was currently enlisting experts to set out its remit.

Primary care minister Steve Brine MP told delegates at the Royal Pharmaceutical Society Conference yesterday that health secretary Jeremy Hunt was working closely with NHS England chief pharmaceutical officer Keith Ridge on tackling prescribing errors.

This work is likely to focus on:

  • Improving communication and preventing errors when patients move between care settings;
  • How pharmacists can support GPs and care homes; 
  • The impact and uses of e-prescribing; and
  • Errors in seven-day services.

It also said there would be a public-facing programme focused on patients’ understanding of medicines, and a piece of work looking at any problems that may arise in the pathway from prescribing to dispensing and monitoring.

Mr Brine said: 'Studies currently indicate that up to 8% of prescriptions have a mistake in dosage level, course length or medication type –a risk which the WHO identifies as “a leading cause of injury and avoidable harm in health care systems across the world".

'Patient education and safe management of information will be at the heart of our efforts to tackle this serious issue. For example, we will need to improve how we use electronic prescribing, as well as how we transfer information about medicines between care settings, where there is significant scope for errors.

'Fundamental to this process is clinical leadership – and that begins with fostering the debate, inside and outside government – around how we can make these essential improvements to our healthcare system.'

A 2012 GMC analysis of prescription items found roughly one in eight patients was affected by a prescribing or monitoring error and, although only one in 550 errors was found to be severe, prompted changes to GP training.

A more recent audit of 500 practices’ prescribing, published in the BMJ in 2015, found around one in 20 patients received a prescription that should have been avoided as it could worsen their condition or interact with another medication.

GP leaders said at the time that pharmacist-led medication reviews could help boost safety and take pressure off GPs.

Readers' comments (26)

  • Azeem Majeed

    In a study of clinicians' views on priorities for improvement of medication safety in primary care, the top three problems were incomplete reconciliation of medication during patient ‘hand-overs’, inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy.

    https://goo.gl/6EgS8x

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  • In my study of one person's views on priorities for improvement of the NHS and primary care, the top problem was Jeremy Hunt.

    That is all.

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  • The answer is of course that drug prescribing remains with the provider who is managing the condition.....not transfer to GP....hand offs are always risky

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  • The approach needs to be less about 'punishing' doctors for getting things wrong and more open reporting of errors - Book 'Black Box Thinking' by Malcom Gladwell should be a start point in this thought process.

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  • "Reduction of unnecessary prescribing" .... which is why all GPs should have the option of social prescribing. Not just an issue of ensuring engagement with patients in what matters to them, but clearly a patient safety issue.

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  • All valid points! Standardized Discharge Letters , Minimal Prescribing and Appropriate Handover to GP are Essential Tools to minimize prescribing errors! Jeremy Hunt is not supporting Primary Care adequately!

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  • Jeremy Hunt is not perfect but has been and is a champion for patient safety, something we should all be champions for. Question to OBI - if Jeremy Hunt is top of the list of the cause of the problem, what is your ranking on that list?

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  • Cobblers

    Anyone going to query monthly prescribing which supposedly saves waste but also decreases compliance?

    If circumstances permit doing an annual script instead of monthly would reduce the workload by 12X. Of course 3 monthly or 6 monthly scripts would be more likely.

    Less workload, less errors, but pharmacists might suffer!

    What's not to like.

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  • In aviation, systems are designed to reduce errors. The pilots aren't constantly blamed and told to try harder. Look at Martin Bromiley's human factors work featured in Matthew Syed's Black Box Thinking, and the culture/hierarchy barriers in Malcolm Gladwell's Outliers. It is a system designed to produce errors. Not duff clinicians who need a good beating or yet more training.

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  • The whole prescribing process is deeply flawed at system level - at worst it is an unmanaged production line of FP10 with only minimal
    oversight by a clinical system that is on its knees from transaction overload.
    I doubt that the findings by Arnold Zermansky in 1995 in Leeds published in JRCGP are much different today - only 50% had a clinical review in the previous 18 months in his study group of training practices. In a personal communication he thought in ordinary practice it was nearer 33%.
    The arrival of pharmacist as a key role inside GP surgeries is crucial as a manpower issue, but do is root and branch reform inside practice prescribing systems as a developmental strategy. More bodies added to a flawed system will not help in the long term.

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