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GPs should be monitored on care home prescribing, says NICE

GPs’ could soon be monitored on their performance in writing clear and comprehensive prescriptions for care home residents, under new NICE guidance.

NICE is proposing that NHS England area teams should check whether prescribers are ensuring there are clear instructions on how a medicine should be used, including when and how long the resident is expected to need the medicine and, if important, how long the medicine will take to work

The draft quality standard document also states that every resident has a multi-disciplinary review of medication at least once a year.

NICE argues that the guidance will help cut the number medication errors for care home residents, raise their quality of life, and give families and carers greater confidence in service provision.

The draft document quotes research showing that more than a third of care home residents experienced at least one prescribing error, with the most common being incomplete information on prescriptions.

It states: ‘It is important that the healthcare professional who prescribe a medicine also provide all the necessary details about how a medicine is to be used. In particular, clear instructions from the prescriber about when to use “when required” medicines should be given to provide clarity for care home staff if they are administering medicines to residents.’

It adds: ‘Clear system and processes for issuing and recording prescriptions will also help to reduce prescribing errors such as dosage errors and omission of medicines that should have been prescribed. Clear processes should also be in place for repeat prescriptions and also for urgent or acute prescriptions to avoid delays in getting urgent medicines.’

The document also stresses that people in care homes should be supported to self-administer their medicines unless a risk has indicated they are unable to do so.

NICE wants to end the practice of care home staff ‘automatically assuming responsibility for managing medicines, which leads to loss of control and independence.’

NICE deputy chief executive Gillian Leng said: ‘This draft quality standard identifies a need for more person-centred care, better processes to avoid medication errors and integrated working between health and social care.’

The institute is consulting GPs and other interest groups until November 7 before finalising the document.

It comes as GPs are facing greater scrutiny over their prescribing of antibiotics, with Pulse reporting last week that public health chiefs are looking to put targets in the GP contract.

Readers' comments (5)

  • You mean lets get GPs to do more work that suitably qauliified people could be doing but homes wont pay for?

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  • yet another 'marker' that creates more work for under-resourced GPs!
    With all the ways GPs are going to be scrutinised (antibiotic prescribing, cancer referrals etc), won't be any time to do any real medicine....
    Whilst it could be helpful to identify sub-standard prescribing and monitoring of medicines (there's a lot of it about), for those who are already doing a good job, why give them the grief of micro-managing and trying to show up GPs...for what purpose other then vilification by NHS England, patients, CCGs, press and GMC!
    Bye bye NHS, can't say I will miss all these issues

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  • This really is patronising micro-management! Of course GPs should write indications for PRN meds and patients should get a med review. That already happens for the most part and when it doesn't that's wrong so I don't know why NICE need to make a whole recommendation stating the obvious. What next patients with Diabetes should be told to exercise and lose weight.. wait they've already done that one! ha ha
    Doctors should treat patients appropriately and given the time and resources they will. Some nursing home residents may not get a review due to the lack of resources these days and the worried well clogging up the surgery.

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  • well time has come for Govt to employ statisticians and NHS england as gps and Drs so that they can withold abx from first 9 patient out of 10 and investigate every cough with ct scan and specialist referral and sit in the care homes with all the instruction and do away with evil present day GP.'s as obviously these people know medicine better and practice better than present day GP's. Problem solved. money saved everything dunky horry

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  • why is everyone worried. I think best policy from govt would be to employ cqc and statisticians and NHS England chiefs to run gp surgeries and throw away the evil gp. then they can refuse abx to 9 out of 10 patients and then give abx to the 10th patient. stats will look good. NHS england can rund gp surgeries and employ consultants and not scare anyone into gp world as they wont need gp anymore. cqc can monitor itself and will come out sparkling and shining as they know how to run gp surgeries. every one happy.

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