This year North East Essex Primary Care Trust has a large budget deficit. As part of the recovery plan, North East Essex PCT is looking at ways to improve prescribing efficiency and this means a change to 28 day repeat prescribing.

The Department of Health states that

“A 28 day repeat prescribing interval is recognised by the NHS as making the best possible balance between patient convenience, good medical practice and minimal drug wastage”

Nationally and locally it has been estimated that about 10% of l medicines prescribed are wasted. In our PCT this would be approximately £5m currently being wasted in 2006-07. One study found a 28 day prescribing policy reduced the amount of medication wasted by one third.

How will 28 day prescribing affect you?

If you are being prescribed a “repeat medicine” your doctor will now start to prescribe enough of each medicine to last you for 28 days. For example, if you are taking 2 tablets a day you will receive 56 tablets, 3 tablets a day 84 tablets, 4 tablets a day 112 tablets etc. There are some drugs which are packaged in 3 monthly amounts and will continue to be dispensed in these packs e.g contraceptive pills and HRT.

What are the benefits of 28 day prescribing?

• Companies already manufacture a large number of medicines in 28 day patient calendar packs. These packs have patient information leaflets inside and ideally they should not be broken into.
• The government is encouraging companies to manufacture more medicines in this type of packaging. It can allow you to check or monitor that you have taken your medication.
• It will reduce the amount of medicine which is currently wasted when medicines are stopped or changed. It will also reduce the amount which is wasted when partly filled containers are thrown away.
• It will be easier for the doctor to review all of the repeat medicines each patient is taking and also easier for the doctor to see if a patient is not taking any of their medicines.
• It will reduce confusion and the number of mistakes made by patients, especially the elderly, when they take their medicine, as patients will be less likely to have multiple partly filled containers of medicine at home.

Will it cost patients more?

The vast majority of patients collecting repeat prescriptions do not pay prescription charges. If you do have to pay prescription charges and need more than 5 prescription items in 4 months or 14 in 12 months, you can save money by buying a Prescription Prepayment Certificate.
From 1st April 2006 these will cost £34.65 for 4 months and £95.30 for 12
months.
You can order a certificate or get further information from Prescription Prepayment Certificates (PPCs) Telephone Advice/Order Line 0845 850 0030

Repeat Prescription Requests may be submitted in the following ways,

• by personal attendance at the surgery,
• by post,
• by using one of the local chemists who collect prescriptions from the
  surgery.

In all cases it is best practice for patients to use the counterfoil repeat prescription slip (that is the right hand side of the printed prescription) to order instead of writing letters etc.

Further information to help you and your doctor

• Your prescription should last at least 28 days. If you are collecting routine medication more often than this please tell the practice.
• All medicines should last for the same number of days. If you are running out of some items or have too much of some medication, please tell the practice.
• Please bear with us if there is a delay in obtaining your prescription. This is usually the doctor reviewing the medication request or the practice making sure that the prescription is correct.
• Be prepared to attend the surgery annually for a medication review. The doctor is making sure that the medication you are taking is still the best way to manage your medical condition.
• Be prepared for practice staff to ask questions about your medication when you order a prescription.
• Do not stockpile medicines at home, only order those items that you will need until your next prescription is obtained. (usually 28 days).
• Return any unwanted medication to the pharmacy for safe disposal.
• Please order when you still have a few days of medication in hand to allow for possible delay.