PRESCRIBING PILOT
AS THE EVALUATION OF AN ELECTRONIC PRESCRIBING PILOT, WHICH TOOK PLACE EARLIER THIS YEAR, IS COMPLETED, EWAN MORRISON, DIRECTOR OF PHARMACY AT NHS NATIONAL SERVICES SCOTLAND, TELLS SP ABOUT ITS FINDINGS.
SUCCESSFUL PILOT TO BE ROLLED OUT
In November of last year, a pilot was launched in a small number of GP practices across five health boards, which allowed pharmacist independent prescribers (PIPs), who work in the practices, to prescribe electronically.
The pilot was launched as part of the ongoing work to support the current and future resourcing pressures being faced by GP practices and NHS Boards. The Scottish Government had identified an immediate requirement to identify a short-term solution to enable PIPs to prescribe electronically.
A few years ago, the shortage of GPs in Scotland meant that some pharmacists were prescribing in GP practices. Difficulties faced by the pharmacists at that time included not being able to use their prescribing paperwork in local printers and the prescribing software was not designed for pharmacist use.
At that time, however, the numbers of PIPs were very small and so there was no major issue arising from such problems.
Over the last couple of years, however, the numbers of pharmacists working in GP practices has reached around 100, and it is anticipated that this figure will rise substantially in the future. It was clear therefore that
8 - SCOTTISH PHARMACIST
these problems were becoming a major issue.
The heavy workload currently being experienced by GPs indicated that it was necessary to reduce GP time that was being spent on prescribing issues.
The pilot, which ran from November last year until the end of January this year, featured the project team testing new technology to simplify the prescribing process.
Unlike the previous system where everything was handwritten, this new system allows the PIP to log into the system and issue the prescription in a GP10 format. The PIP generates the electronic prescription details, inputs an agreed national read code into the system for governance purposes and annotates the electronic notes, which means that the interaction is recorded electronically in the consultation notes. The prescription is then printed as normal, and is stamped on the bottom right-hand corner with the word ‘PIP’ and annotated with the prescribing PIP’s General Pharmaceutical Council (GPhC) registration number.
The pilot was carried out across five Health Boards - NHS Forth Valley, Grampian, Greater Glasgow and Clyde, Highland and Lanarkshire – and involved 22 PIPs and over 1800 patient interactions.
Once the project had finished at the end of January, the project team carried out an evaluation across the five Boards.
It became immediately evident that those involved had quickly noted the benefits of this electronic system. GPs were particularly positive above its advantages, with many remarking that they had witnessed a definite reduction in re-entering information. They also appreciated having an ongoing record of a patient’s history with the PIP.
The PIPs involved also felt that they had benefitted from the pilot system, particularly in terms of the fact that it had reduced the time spent on prescribing – particularly in terms of repeat prescribing.
In the Highlands, in fact, there was one notable comment where a PIP stated that the new system had reduced the time for a patient consultation by five minutes.
The only ‘negative’ comment that the project team encountered – and it was more of a constructive suggestion than a negative comment – was that the frontline staff in some GP practices didn’t know anything about the new management system. It was therefore noted that these staff members needed to be updated and kept
informed.
‘Once we had completed the evaluation,’ Ewan told SP, ‘we reported the findings – particularly the benefits - to the Chief Pharmaceutical Officer, Rose Marie Parr - as project commissioner. She promptly signed off on the process and recommended it to NHS Boards for implementation.
‘The system is now at roll-out stage, so many more PIPs will soon be benefitting from this electronic prescribing system, and those GP practices will find their prescribing time noticeably reduced.
‘This is an optional process for GP practices to implement, but if a PIP is practising from any practice it would seem prudent to introduce this as soon as possible. Communication has been cascaded to Boards on the topic to assist this choice and this can be accessed through local pharmacy primary care teams.
‘It is essential to note, however, that this move is just a temporary solution. The ongoing reprovision of GP IT systems continues and it is expected that a longer-term solution for all prescribers will be provided when this is complete.’•
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