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RCGP revamps MRCGP to put more emphasis on safe prescribing

The RCGP has revamped the clinical skills assessment component of the MRCGP exam to include more of an assessment of safe prescribing skills, Pulse has learnt.

The RCGP said its case management group would now be putting a greater emphasis on patient safety issues, following proposals from the lead investigator into a GMC-commissioned study of GP prescribing that was published last year that found there were errors in one in 20 GP prescriptions.

The PRACTICE study has already prompted the RCGP to change its curriculum to include a requirement for GP trainees to demonstrate competence in prescribing and medicines management.

But in an exclusive interview with Pulse, Professor Anthony Avery, Professor of Primary Health Care at the University of Nottingham, said he had met with the RCGP and had made recommendations on how the CSA also could be changed to examine prescribing skills.

Professor Avery said: ‘We’re working particularly hard with RCGP. We’ve been helping giving suggestions in terms of how prescribing and safety aspects could be further incorporated into their CSA, so GP registrars would know there’s a good chance they’ll be examined on a prescribing-related issue, and that obviously helps drive the leaning.

‘There won’t be scenarios that are entirely prescribing, but there are ways to weave it in a little more than it is already.’

He said that that the sorts of issues that could be addressed include ensuring GPs selecting the right dose, especially in prescribing for children as well as providing the correct dose instructions to patients rather than writing ‘as directed’ on the prescription. GP registrars could also be tested to make sure they know all the patients’ details, such as co-morbidities, renal function and age, when making prescribing decisions.

He is also working with the RCGP to develop learning materials for GP trainees, GP registrars and GPs on prescribing skills and safety.

A spokesperson for the RCGP said: ‘The CSA has always included prescribing. Following Professor Avery’s very interesting presentation, the case management group will continue its established strategy of writing prescribing issues into the cases and now with greater emphasis on patient safety issues.’


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