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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.


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