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Senior GP leader had to sign ‘220 paper prescriptions in one day’

Senior GP leader had to sign ‘220 paper prescriptions in one day’

The BMA UK GP Committee co-chair has called for urgent workload solutions after he had to sign a ‘record’ 220 paper prescriptions in just one day.

On the occasion, Dr Andrew Buist was one of two GPs left looking after 7,800 patients due to sickness and staff annual leave.

The Blairgowrie GP said doctors ‘have better things to do’ and that the Scottish Government must deliver on ‘promised’ electronic solutions with appropriate funding.

He told Pulse: ‘It’s a 19th century method of signing prescriptions which we should be moving on from and I know that the Government has been looking at how to do it. I know they were looking at it in 2004 and 19 years later we are still operating on paper.

‘We are inconveniencing patients and cutting down trees and using gallons of ink – and wasting clinicians’ time.

‘It’s not a safe system either as prescriptions can get lost. There needs to be more focus on that.

‘There is a working group working on it now and I have seen presentations that they have done, they look serious for once. The tech exists to do this, but there’s some questions on the funding.’

Dr Buist’s fellow GPC UK co-chair Dr Alan Stout, Northern Ireland GPC chair, tweeted in response that paper still having to be used by GPs represent ‘a huge waste of time and money’.

A Scottish Government spokesperson said: ‘We are working with National Services Scotland and the National Digital Service to fully digitalise the prescribing and dispensing routes for medicines through the Digital Prescribing and Dispensing Pathways Programme. This will support a paperless system, utilising advanced electronic signatures, across primary care, including between GP practises and pharmacies.

‘Electronic Transmission of Prescriptions (ETP) has been operating in Scotland since 2006 alongside paper prescriptions which are a legal requirement until advanced electronic signatures are established.’

Earlier this year, the BMA warned that general practice in Scotland is in ‘a sustainability crisis,’ with almost a quarter of a million more patients than 10 years ago and almost 90 fewer GP practices.

The research revealed that while the number of GP practices in Scotland is falling, the average number of patients per whole time equivalent GP has increased from 1,499 to 1,687.


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Please note, only GPs are permitted to add comments to articles

David Church 12 July, 2023 1:44 pm

I didn’t realise I had to count them.
Is that more than 3 inches ?

Monica Stevens 12 July, 2023 1:54 pm

Yes when the GMC says you need to open the record before you sign the prescription, so you can check all the details, you realise that they are putting you in an impossible situation.

If you gave 1 minute to each script that would be 220 minutes , or 3 hours 40 minutes of work. No wonder many of us just sign them and hope the prescribing clerk has done their job well.

Turn out The Lights 12 July, 2023 2:14 pm

Spot on MS the establishment don’t understand the front line,primary or secondary care.Hence why the profession is in the state it is.

Anthony Everington 12 July, 2023 2:17 pm

We train and employ pharmacists and the they do virtually all the repeat prescriptions. As a rough estimate, the workload has halved and safety significantly improved. Virtually all the prescriptions are now electronic and sent to the patients chosen pharmacist or can be sent to “any” pharmacist. What is going on in Scotland?

Steve McOne 12 July, 2023 3:09 pm

I like Andrew. But surely there are bigger fish to fry than moaning about signing scripts? I’d happily sign 1000 if that’s all I need to do for a day.

John Graham Munro 12 July, 2023 3:17 pm

Staff shortage——–No locums to dump this on?

David Jarvis 12 July, 2023 3:28 pm

I’d assumed we were all on electronic prescriptions in the UK. How naïve am I. but then 15 years ago we were doing that list size with 3 1/2 Gps

Ian Haczewski 12 July, 2023 4:17 pm

Any locum we have down here say it is absolutely not their job to sign scripts and just don’t do any .

Simon Gilbert 12 July, 2023 5:18 pm

Probably takes about 25% of the time it does on Emis Web to electronically sign at the moment.

Richard Greenway 12 July, 2023 8:00 pm

Proves that EMIS web isn’t available North of the border

David Turner 12 July, 2023 10:57 pm

I reminisce fondly about the days we signed paper scripts. So much quicker.
Electronic prescribing painfully slow!

Fiona Black 13 July, 2023 11:25 am

EMIS is slow and can take 90seconds per script electronically at times.

Paul Frisby 13 July, 2023 3:46 pm

Agree with those above. Electronic prescriptions added an hour to my day. So many pop-ups and so much hang-time. Paper was much quicker for the signer

Just Your Average Joe 13 July, 2023 5:19 pm

I signed 627 scriprs recently in 1 evening covering my colleagurs on holiday and off sick.

Sadly my salaried colleagues do a limited allocated workliad, leaving partners to pick up the slack, and the government continues their campaign to destroy partnerships.

Just wondering who will be there to see the patornts and sign the scripts if I wasnt there.

Dont even start on the 325 path results that I did after a 12 hours day, after a quick bite working until 3am, before returning for morning surgery and another day on call.

Even woth Allied health prpfessionals to help, noone replaces a GP, and payong 2 or 3 to try is just bankrupting the practice, along with the high cost and again limited workload done by locums

I am not berating salaried and locum colleagues, but BMA needs to grow a pair, and represent practices, as this new pay rise offered is coming from partners pockets and will be another nail in the coffin for partners.

Tim Binmore 13 July, 2023 5:58 pm our Scottish colleagues do house calls in a horse and carriage as well? Amazed they don’t have electronic prescriptions.

Carrick Richards 17 July, 2023 2:00 pm

No surprise, this is not exceptional. In addition add econsults, workflow-tasks, pathlinks, Docman, messages, certificates, reports, telephone calls, consultations, urgent extras, ambulance advice…… and you begin to see why Hunt/ Hancock’s pledge to provide 6000 WTE more GPs (only ~7200 still to go) needs to be fulfilled.

David jenkins 18 July, 2023 4:56 pm

when i, as a locum, go down to our local surgery on a monday morning, there are regularly 300-400 scripts already on the desk at 8.45am (yes – 8.45), left over from the previous friday. i log on, and sign the lot before starting – just to try and show that not all locums, salaried, partners etc are a bunch of workshy layabouts.
then i see patients, do phone calls, sign more scripts etc. i keep going till the end of my shift – usually with a baguette somewhere in the middle.
i make sure all referrals are done, and signed, before i leave.
then i go home.

whatever shit happens when i’m there, i deal with it. if a surgery takes the p*ss, and dumps a load of crap on me, i refuse further wok – though in 15 years locumming it hasn’t happened yet.

i qualified in 1976, and i’m 73, running off one lung, and had to retire early in 2007. i still want to contribute – but not kill myself in the process. i do two days a week, max.

so – go to work, get on with it, go home, get paid.

don’t moan about it – if a locum/salaried says “no”, find another “old school bare knuckle” doctor like me, treat them properly, and i’m sure you’ll have a nice surprise. cut the hours of those who aren’t flexible, or don’t pull their weight – remember, THEY have a mortgage, i don’t !

and yes – i know about partnerships, finance, premises etc etc etc. i ran a single handed, rural, dispensing practice in west wales for over 30 years, and finally took early retirement when i had a dvt in my right arm, and a Hb of 5G%.

no – i’m not a hero, i don’t want a blue peter badge (though the MBE would be nice !), just an ordinary bloke doing what he was trained to do.

i’d rather spend the time i have left treating those who need treating, helping those who need it – including colleagues – and spending less time arguing with those (politicians) who aren’t going to listen, and are too busy trying to feather their own nests.

just though i’d share some of that !!!!

(from “the thoughts of dai jenx”)

Iain Chalmers 18 July, 2023 5:33 pm

Congrats & chapeau to DJ

Problem is current NHS isn’t what I or I suspect my colleagues signed up to on graduation. I’m an adult, deserved treated like that & not micro managed by non medically qualified numpties or politicians who actually struggle to sit the right way on a lavatory.

Quite happy with personal list (got patients I deserved over the years, a hint here if a prat) & trained them well. That going is biggest issue IMHO & not going to be sorted in any reasonable timeframe.

What I see now scares me & despair when recently tried to pilot emergency system with axillary vein thrombosis. Once physically seen F2F everybody & his pet dog wanted to tip up

David jenkins 18 July, 2023 6:23 pm

Iain Chalmers
u related to (the late) theo chalmers by chance ?