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At the heart of general practice since 1960

How practice was able to drive out script fraud

Disputes with pharmacists and patients over lost scripts?

Dr Tim Gietzen explains how his practice beat the problem

A GP I know who practises in the West Country was supplying weekly benzodiazepine scripts for an addict. Every week the secretarial staff generated a script, every week he signed it and every week the pharmacist's driver picked it up.

Then came a week that was slightly different. My GP friend was certain he'd signed the prescription but the patient swore he'd never received the drugs. The pharmacist wasn't particularly helpful; the prescription hadn't arrived so it wasn't his problem.

The GP happened to mention this to a colleague and learned that he'd had a similar problem, but with a different chemist. To cut a long story short it turned out that half a dozen pharmacies were employing the same driver.

When the driver got back to his van he was going through the prescriptions and helping himself to whatever took his fancy. He might not have known much about pharmacology but he knew what he liked. Not a very sophisticated fraud and one that was bound to be found out soon enough, but it got me thinking.

I was pretty confident the same thing had never happened to us, but there was nothing to stop it happening. Nor did we have any

system to clarify the regular disputes we periodically had with pharmacists and patients as to who lost what and where.

So we devised a solution. It sounds like hard work, but really it isn't. We insist that all drivers sign for each and every script they pick up.

Every pharmacy has a folder with a simple notebook in it. As each signed prescription is put in the folder, the name is entered into the log. A

separate page for every day. The driver checks the prescriptions against the names and signs for what he takes.

There was initial scepticism and a fear that it would add to staff workload but we've found the reverse to be true. It adds about 10 minutes a day to the work of the prescription clerk but saves much more than that in time no longer wasted on sorting out disputes.

If a patient telephones to say his prescription is not at the pharmacy or hasn't been delivered it's the work of a moment to check whether it's been picked up or not.

It is also exceedingly useful to know exactly when the prescription left our care. If we are to be able turn scripts round in 24 hours it is vital to be able to demonstrate where delays outside our control might occur.

So far it's never happened to us but in these days where patients use pharmacies to collect prescriptions it's possible to envisage a situation where a patient suffers harm from non-delivery of a prescription drug. If we can demonstrate when a script was done and when it was picked up, the buck will stop somewhere else.

Tim Gietzen is a GP in Eastbourne

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