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Receptionists' 'practical judgements' help ensure safe repeat prescribing, study finds

GP receptionists and administrative staff make important ‘hidden' contributions to making repeat prescribing safer, research has found.

Researchers from Queen Mary, University of London, analysed how GPs, receptionists and other administrative staff contributed to, and collaborated on, repeat prescribing routines across four UK practices.

They found repeat prescribing to be a complex, technology-supported, ‘social' practice, requiring collaboration between clinicians and administrative staff. But they also found a ‘model-reality gap' exists between formal prescribing protocols and the real time activity of repeat prescribing, and that staff often bridge this gap by making ‘practical judgments' which helped to safeguard patients.

Repeat prescriptions account for up to three quarters of all medication prescribed and four fifths of medication costs in general practice, while repeat prescribing has long been recognised as a significant quality and safety concern.

The study, published in the BMJ, concluded that over-reliance on electronic health records can affect the quality and safety of repeat prescribing, but that this risk can be offset by the judgement of the reception staff.

The authors said their findings highlighted the need to ensure that training in repeat prescribing goes beyond technology to help safeguard patients.

In an accompanying editorial, Professor Tony Avery, professor of primary care at the University of Nottingham and a GP in the city, said: ‘It seems reasonable to encourage well-trained receptionists to use their initiative in repeat prescribing, but practices need to ensure that members of staff do not step beyond their levels of knowledge and competence.'

Click here to view full paper: http://www.bmj.com/cgi/doi/10.1136/bmj.d6788

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