Oops!
I have been interested to see your correspondence, which was e-mailed to
me by Owen Dempsey.
The organisation of repeat prescribing systems are an irritation often
given ever decreasing priority in surgeries - set up a system and let it
roll.........The problem is we are responsible for the bit of paper that
end up in the patients hand.
Computerisation has undoubtedly given us the opportunity to review our
performance with repeat prescribing, but it can lead to sloppy habits.
We had a computer system which would allow the receptionist to over-ride an
expired repeat, with the advice to make an appointment - you can guess what
tended to happen - over-ride, rather than bother the doc.
We have changed to Torex for our system, and although it has its problems,
the doc has to be more pro-active in re-authorising repeats, and if a
decision is made to bring the patient in, then this can only be over-ridden
by a doc. You can imagine that this generates a lot of extra work and yes,
it is a real b...-ache, but it leads to tighter repeat management, and
hopefully better drug monitoring.
For an incentive, if a partner has seen the patient recently, and hasn't
updated the repeat, then the notes are left in the respective individuals
tray - this leads to better consultation repeat review.
As for the 'unseen' scrips - the 'can he have...', these are individually
labelled and left with the notes (yes, we still use them), for the doctor
of the day to make a decision.
We decided to instigate this system, as our staff were getting cheesed off,
to say the least. On review, we now realise that we are on safer (but not
perfect) medico-legal ground, and the staff are much more inclined to make
that cuppa, etc!
Au revoir, be gentle with me.
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> From: Jel Coward <[log in to unmask]>
> To: [log in to unmask]
> Subject: Repeat prescribing practice
> Date: Tuesday, April 21, 1998 01:50
>
> 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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