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Subject:

Re: RFA & scripts

From:

"Laurie Miles" <[log in to unmask]>

Reply-To:

Laurie Miles

Date:

Wed, 11 Nov 1998 19:06:47 -0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (82 lines)

See below for Adrian's (good) reply.

Alternatively...
We have always allowed patients to have unauthorised scripts, but the
patient's notes are pulled and reviewed by us (and the computer records),
prior to signing the script.

The options we had were:
1-Reauthorise scripts for a further period of time.
2-Put a Post-It note on script advising pt to attend for review (and
documenting this).
3-(rarely) Issuing a script for a smaller amount, or refusing and asking pt
to come in.

Most of the time options 1 or 2 apply. We rely on the patient to come in,
merely advising them that they are due review. Most of our patients comply,
most of the time. This means that we do not have patients asking for
appointments urgently for their repeat medication, when they require a
simple routine review. We have a lovely flowchart (done in Powerpoint) up in
reception detailing our procedure.

Unfortunately, with the RFA compliant VM6 I can no longer do this - I have
to reauthorise a patient's repeat medication to issue a script. I don't
think the NHS IT folk who write such things have a clue what actually goes
on in GP - I suspect they visit one or two practices, and think that *their*
way of working reflects all of GP IT practice.

We have *never* been asked for our opinion in the National Vamp User Group
regarding matters in the RFA by its authors, and we can reasonably be deemed
to represent a fair number of GP IT users. Have any of the other UGs ever
been asked for their opinion regarding proposed changes to RFA. Should we be
writing en masse to (whom?) to tell them how we want to be involved and
consulted? Or are RFA decisions cloaked in the same secrecy (with parties
signing the Official Secrets Act) that the NHS drugs black list has?

Could a campaign be brewing?....

Laurie Miles
NVUG Executive & GP St Helens
[log in to unmask]

>Laurie Miles wrote at 08:34 on 11/11/98
>>rather petty issues such as stopping us issuing an unauthorised script
>>(latest RFA compliant VM6 will no longer allow me to do this, changing the
>>whole way we run our repeat prescribing system)


>Hmm.  Thinks...
>When a member of staff inspects a pateint repeat prescription record
>and finds an item requested is expired they should flag it as
>requested which should add it to a queue or list of items awaiting
>review by doctor.
>At review by doctor the options should be
> - to refuse, with suitable
>message printed or not for patient ("see me", "get BP measured by
>nurse")
> - to print a limited supply, one week instead of two months for
>instance, with message as above;
> - to reauthorise for the original or a different number of issues,
>which needs access to the medical record without losing one's place
>inthe queue;
> -  to remove from the queue
> - to leave in the queue without coming to a decision
> - to telephone the patient by clicking a TAPI link
> - to see the patient's hospital notes and letters, appointment info
>etc.
>
>After the doctor's pass through the queue the authorised or reduced
>quantity prescriptions should be automatically spooled, with the
>various messages.
>Because these are indivdually notable items they should be printed
>one item to a sheet on FP10, and it should be emphasised on them
>that they have been reviewed.  A couple of ** in a suitable place
>would do.
>
>Could we have that rolled out for Xmas please, you developers?
>--- OffRoad 1.9r registered to Adrian Midgley



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