By Clare Thomson, RPS Chief Pharmaceutical Officer's Clinical Fellow 2023-24

In 2021 the Department of Health and Social Care published the National Overprescribing Review, Good for you, good for us, good for everybody, which made 20 cross-system recommendations to help reduce overprescribing in England.   

In response, NHS England commissioned the Royal Pharmaceutical Society (RPS) and the Royal College of General Practitioners (RCGP) to create a Repeat Prescribing Toolkit to improve the safety and efficiency of repeat prescribing systems in primary care in England.  

As one of the Chief Pharmaceutical Officer’s Clinical Fellows 23-24 hosted by RPS, I have had the unique opportunity to oversee the creation of the Toolkit and work alongside the co-chairs Clare Howard, FRPharmS and Michael Mulholland, RCGP Honorary Secretary. 

Working collaboratively  

Creation of the toolkit involved multi-professional collaboration across all levels of primary care, recognising all members of a practice or primary care network (PCN) team may interact with repeat prescribing as part of their daily workload. This was a once-in-a-generation opportunity to produce new written guidance about repeat prescribing; the last guidance was published over 20 years ago by the former National Prescribing Centre. 

Patients were at the heart of our collaboration. Our patient representatives were integral to the co-production of the Toolkit, and we always sought to focus on what matters most to them – to receive their medicines in a safe and timely manner.  

Our patient partnership agreement and leaflets will help practices engage with their patient participation group and embed this process from the point patients register with a practice and/or are first prescribed a repeat medication. For existing patients, it provides an opportunity for a structured medication review with a pharmacist or GP. 

Stakeholder engagement 

With the chance to shape future practice through the Toolkit, there was real enthusiasm from stakeholders on our working group. We provided a very clear scope to ensure we were delivering a key message: to improve patient safety and efficiency within the system.  

I have learnt that working at a national level takes time to build relationships with stakeholders and requires the skill to listen, acknowledge and come to mutual agreements. The working group recommendations will hopefully lead the way for future work, as the Toolkit is only one element of improving repeat prescribing and the care of patients.  

Patient safety and ongoing research 

During production of the Toolkit we worked closely with the patient safety team at NHS England to review areas of harm in relation to repeat medicines.  

I had the opportunity to research some of the patient safety themes in more detail including undertaking a thematic analysis of coroners’ prevention of future death reports which reference medicines on repeat prescription, over a 5-year period.  I was delighted to present my research at the RCGP annual conference in October, will have a poster at RPS conference in November and the full manuscript is pending journal publication.  

Sharing good practice 

The Toolkit has also been an opportunity to share good practice and celebrate the work of hard-working teams in primary care. I hope others enjoy reading the success stories of various practices and PCNs that have undertaken quality improvement projects, streamlining repeat prescribing processes, releasing staff time and reducing medicines waste.   

Read the RPS/RCGP Repeat prescribing toolkit. 

Read more RPS news stories.