Stick to your guns. At a recent PGEA course, an MPS doc said that the 
commonest reason for litigation is repeats, nearly all of which never make the 
headlines as they are settled out of court becos they are usually 
indefensible. Why? becos most are due to pts not being reviewed when on 
regular medication. He gave a good example of the pt on hypotensives getting 
rpt after rpt with review dates ignored and reauthorised by staff, then had 
stroke. His advice: ignore review dates at your peril. He suggests at least 
annual review. Our surgery is going to change its policy soon.

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From: 	[log in to unmask] on behalf of Jel Coward
Sent: 	21 April 1998 13:50
To: 	[log in to unmask]
Subject: 	Repeat prescribing practice

Hi all

I have been horrified to discover what has been happening in our
practice with some repeats.

This was discovered when I said that with our new computer system we
should set password authorities so that staff could only issue
authorised repeats ie not re-authorise - and of course not issue acute
scripts.

The staff (receptionists) were horrified 'What are we going to do with
people who have run out of repeats?'  My suggestion that this was a
doctors responisbility was met by derisory laughter.

So the bottom line is that I am signing repeats for patients who may not
have been reviewed, or may not have had a particular drug or condition
reviewed (and documented).  I feel that my ass is very exposed here (not
a pretty sight).

3 questions

1. Does anyone beleive that it can be right to allow staff to
reauthorise meds without documented Dr approval?

2. Does anyone beleive it is fair to expose your partners to such risk
by asking them to sign repeats that you have not authorised and
documented (and perhaps not seen the patient for 3 years)?

3. Does anyone do this - come on, be honest - I have been.

4. Does anyone know of any guidance/rulings on this from
RCGP/GMC/MDU/MPS?  Or any guide I could get to 'good practice'?  Or any
references to papers looking at repeats?

5. Does anyone think that it is not negligence to allow your staff to
prescribe?


I was shouted down at a practice meeting (not literally)  - you will
have guessed I am after views and supportive documentation - or you can
all also shout me down if I am way of the mark of pragmatism.


Cheers all :)
-- 
Jelly Bean              [log in to unmask]

When you get fed up surfing....
....go find some waves.





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