‘Now they want to take away our prescriptions’

Dr David Turner on how seemingly small bureaucratic changes – like the disappearance of paper FP10s – have a bigger impact on day-to-day general practice than policymakers may think

Over the years there has been a slow accumulation of annoying little irritants that push GPs closer to the edge. Such as the relentless need to annually prove we know what colour a fire extinguisher is, and that we are aware it is not best practice to discuss the state of a patient’s genital warts in a full waiting room. These tasks, although pointless, we have all learned to live with in the same manner that one adapts to co-existing with midges in rural Scotland during the summer.

On returning from holiday recently though, I discovered something that didn’t so much as nudge me a bit nearer the edge but rather barged into me like an overweight rottweiler who had been at the testosterone gel. My printer was smaller – yes, visibly lower in height – because, as I soon discovered, the paper prescription tray had been removed. Apparently, due to CQC requirements.

At this point, I have to admit to a love-hate relationship with my printer. It is one of mostly hate, but to have half of it suddenly ripped away from me was like losing half of your worst enemy; less to tangle with and no longer a fair fight. True, it makes it lighter to pick up and hurl across the room when it stops working in the middle of surgery, but I have suddenly lost the ability to print off FP10s.

What sort of dinosaur still does that you may ask? Well, this one.

For those younger GPs out there, uses of a paper FP10:

1. Delayed prescription. When little Johnny has a virus but you just know mum will go ‘shopping ‘around all the OOH facilities until she gets amoxicillin, a paper prescription with the instruction ‘only use this if he gets worse in the next few days’ can reduce antibiotic prescribing. Just having the ability to get antibiotics, without actually filling the prescription, is sometimes enough for anxious parents.
2. In the age of relentless and random medication shortages and when you know patients may have to shop around multiple pharmacies to find the medication they need, a paper FP10 is the only way to do this.
3. To claim back for medications used in house such as local anaesthetic in minor surgery and steroid injections we need paper FP10s.
4. Most important of all though, in the theatre of general practice, the paper prescription can be the best cue to the loquacious, ‘bum stuck to chair’ patient that the consultation is over and its time to go. The phrase ‘your prescription will be sent electronically to the pharmacy’ is nowhere near as powerful a coda to the consultation as handing the patient a signed FP10 with a subtle glance towards the door.

Now I am fully aware that the bods in the CQC who come up with this nonsense know nothing about the realities of our job as they have given it up to become professional nosey parkers. So, for their benefit: There is no risk having printable prescription in our rooms. Apart from the fact we are quite literally sitting next to our printers, even if a patient stole a stack of printable prescriptions, they are blank and no use to them.

As for the idea that FP10s can be printed off centrally in reception, well let me put this simply, receptionists are what we in the trade refer to as very, very busy people and running back and forth to doctors’ rooms to get prescriptions signed is a non-starter.

As a postscript to this tale, you will be glad to know this old grump stamped his foot down and got his prescription tray back.

And as a post, post-script, it has broken down. Normal service has resumed.

Dr David Turner is a GP in Hertfordshire