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TPP upgrades practice systems in wake of GMC prescribing error report

One of the country's biggest GP software providers has implemented a raft of changes to almost 2,000 practice systems in the wake of a GMC-funded study which estimated there are errors in one in 20 GP prescriptions nationally.

The PRACTICE study, published in May, looked at prescribing in a random sample of practices using a range of different software providers, and found on average 4.9% of prescriptions contained an error, although most were minor. The study prompted the RCGP to review its training curriculum and calls for GP systems to offer ‘smarter' prescribing alerts.

Now TPP SystmOne has become the first software provider to implement a series of improvements based on the findings of the study.

The changes include:

  • warnings for clinicians who issue a repeat medication without appropriate tests
  •  allowing clinical reports for patients who are on an active repeat medication and who may be missing tests in their patient record
  • changes to encourage clinicians to partake in more active monitoring of patients prescribed drugs such as warfarin and methotrexate.

TPP is understood to be the first GP systems provider to make changes in the wake of the report, which attracted widespread national attention. The country's largest provider, EMIS, told Pulse it had not made any changes because its new system already incorporates many of the report's recommendations.

Dr Chris Bates, software developer at TPP, said: ‘The safety of our prescribing functionality is of paramount importance to us. We continually analyse SystmOne and, in consultation with clinicians, make developments to it that will not only improve patient care but also increase efficiency in general practice.'

Professor Tony Avery, lead researcher on the PRACTICE study and professor of primary healthcare at the University of Nottingham, said he was pleased at the move, but added: ‘The real issue is trying to tackle the number of low-level alerts people get. Hand in hand with these welcome developments, we need to look at how we reduce some of the less necessary alerts.'

Dr Bill Beeby, chair of the GPC prescribing committee and a GP in Middlesbrough, said constant warning messages on different GP systems meant GPs were ‘monotonously' pressing the cancel button.

He said: ‘We get warnings about aqueous cream telling us there are no warnings. You get warnings about things you are deliberately doing, such as reducing blood pressure.

‘The biggest concern is that the warnings look so similar and the volume is so huge that you risk missing potentially serious ones.'

However a TPP spokesperson said it had decided against reducing the number of warnings in order to reach a ‘happy medium': ‘We continually take feedback from our users, and while some clinicians may feel there are too many warnings, there will be an equal number who believe there are too few.'

Dr Shaun O'Hanlon, clinical and development director at EMIS, said: ‘The smart software called for by the GMC is already being implemented – an increasing number of GPs and pharmacists are using EMIS Web, our integrated record system, and it has the very latest tools to make prescribing safer.'


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