As individuals who are legally entitled to sign prescriptions in a GP surgery, one element of activity that emerges as an element of significant risk, is that pharmacists Independent Prescribers who are working in GP surgeries may be asked to sign all of the repeat prescriptions that the GPs have approved as part of the managed repeat prescribing service. The thinking behind this may be that, once the clinical reasoning behind issuing the repeat has been undertaken by a GP, then the signing of large batches of prescriptions is a relatively time consuming role, but one that is considered to be merely administrative. The idea is that if someone other than the GP signs these repeats, then this will give the GP more time to engage in other activities.
Whilst it is possible to understand the thinking behind such a process, if this were to happen, then the pharmacists involved in signing the repeats would be directly exposed to the liability that emerges for many of the prescribing mistakes currently being made by GPs. It is vital that pharmacists do not just work administratively and blindly sign repeat prescriptions issued by someone else as this would represent a significant shift in liability from GPs to pharmacists. Indeed, this superficial but risk laden activity is one that the underwriters would be unable to provide indemnity protection for.
As an alternative however, benefits would emerge if the pharmacists involved in the managed repeat prescription programme, rather than simply sign batches of prescriptions studied the detail of each prescription, checked the patients records and engaged their pharmaceutical knowledge. In such a way, should they ultimately make valuable clinical interventions, such as spotting the interactions, correcting dosages and even querying the prescribing rationale, then undoubtedly the entire repeat prescription programme could become much safer than is currently the case.
This activity would be transformed from a risky but largely administrative one where pharmacists became part of the problem and not part of the solution, to a very valuable one to be undertaken by pharmacists applying their unique skills around medicines. This much more detailed intervention by pharmacists would go some considerable way in reducing errors in GP surgeries and ultimately would help deliver wider benefits for patients and the NHS.
Whilst insurance is not provided to sign batches of repeat prescriptions in the administrative fashion as described above, where the liability of GP prescribing errors is simply transferred over to the pharmacist, the ‘Signing prescriptions for the Surgery Repeat prescription programme’ extension provides cover to pharmacists who are involved in the more detailed clinical intervention process as described above.
- You can choose £5 or £10 million indemnity cover.
*The insurance included with PDA membership is arranged and administered by The Pharmacy Insurance Agency (PIA) Ltd who are authorised and regulated by the Financial Conduct Authority (Register No 307063).