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PATIENT PARTICIPATION
Repeat Prescribing Focus Group at
Caen Medical Centre
on Tuesday 13th Sept 2011
Attendees
Dr Brian Bennett
Dr Hugh Bradford
Dr Hazel Marquiss
Julie Tanton
Clare Maynard
Christopher Branston
Mark Brent
Teresa Lywood
Leslie Smith
Andrew Gill
The practice had invited 23 patients who use the repeat prescribing processes within
the practice to attend this focus group meeting, unfortunately only 5 patients were
able to accept this invitation and attend the meeting today.
Welcome/ Introduction
Dr Bennett started the meeting by thanking everyone for taking the time to attend.
He explained that we hold patient focus group meetings on a quarterly basis inviting
selected groups of patients with particular needs or conditions to discuss how we are
doing at meeting their needs, the experiences they have encountered and how we
might improve our services by asking them for feedback. Everyone around the table
introduced themselves to the group. The following topics were raised for discussion.
Existing processes for ordering prescriptions
Most of the patients present stated that they bring their repeat slip to the practice and
then collect their medication a few days later at the chemist of their choice. They
stated that this system works well for them and they did not encounter problems
often. One patient present had experienced major problems when using the RPS
scheme offered by the chemist, his medication was often not ready for collection on
the date it was due and the chemist would say they could find no trace of his
request, he has now reverted to bringing his repeat slip to the practice. Dr Bradford
explained that we were already aware of a number of patients who had encountered
problems with this scheme and that it was not generally liked by the partners, but it
was a scheme offered by the chemist which the practice had no control over. The
practice agreed to feed this patient’s concerns back to the local pharmacists when
they next meet with the practice. This patient also commented that he had
encountered language barriers with the local pharmacist and again Dr Bradford
explained we had no control over who the pharmacies employed.
When asked only one patient present was aware of the online ordering system and
he currently did not use it. Some said they would consider using it other said the
method they used worked so did not feel the need to change. It was agreed that this
method of requesting medication needed to be promoted more by the practice.
Most of the patients present were unaware that they could fax or email a request to
the practice for their medication and again it was agreed that the practice should
promote these options.
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Reasons for NOT accepting medicine orders over the telephone
Dr Bennett explained that it is practice policy not to accept request for medicines
over the telephone, this is mainly due to safety aspects and to eliminate the potential
for any errors to occur. He explained that many medicines have very similar names
but can be for very different conditions and potentially harmful if a patient was issued
the wrong medication. All the patients present said they did not have a problem with
this policy and one patient even commented that if we did start to accept these
requests over the telephone that this would increase the volume of calls coming into
the practice making the telephone lines busier and more difficult to contact the
practice for other matters.
Blister Packs
Only one of the patients present was aware of blister packs but had not had personal
experience of using them. Dr Bennett explained that these packs are made up by
the pharmacist and contain sealed pockets which hold the patients medication for
that day, which can also be split into the time of day they need to take the medication
e.g. breakfast, lunch time, tea time and bedtime. Blister packs are only used for
patients who can not remember to take the correct medication at the correct time.
The patients present felt that these were a good idea for this type of patient.
One patient explained that it can be very confusing for patients when their
medication is dispensed in a different box or when the tablets look different. Dr
Bennett explained that the practice will raise a prescription for the ‘generic’ name of
a drug and it is the chemists choice which ‘branded’ drug they use and that this
might be different each time often depending on the prices or items available at that
time.
Waste management
Some of the patients present had already seen our display in the waiting room about
waste management and the financial impact waste has on the NHS. The patients
present felt it was a good idea and that it is important that patients are made aware
of these details. One patient commented that it was good that the reception staff
phoned to check when a patient has requested their medication too early. Dr
Bennett explained that the reception staff run a number of checks before the
prescription is raised and will raise any concerns with the GP before it is passed to
them for checking and signing. One patient asked how we know if a patient still
needs all their medication e.g. their condition might have resolved. Dr Bennett
informed them that the patients usual GP will perform a medication review on their
patients repeat medication at least on a annual basis (this will initially be done using
their medication records), if the patient had not been seen or had the necessary
monitoring procedures e.g. BP checks then the patient would be called in for a
review.
Budgets and GP’s Obligations
Dr Bennett explained that the practice does hold a prescribing budget that we are
expected to keep within and that over the past few years this has been achieved by
a small margin. Dr Bradford explained that we receive guidance and
recommendations from the Prescribing Advisor at the PCT on how we might be able
to make savings on our budget. This will sometimes result in patient’s medication
being changed to an alternative drug which is the same but cheaper, e.g. when a
drug has come off licence the price often falls. One patient asked if this is why the
GP often does not treat an acute problem immediately but tells the patient to return if
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their symptoms do not improve, Dr Bradford explained that acute prescribing does
not have a great impact on our prescribing budget as often these medications are
quite cheap, but that it is the repeat items that can be very expensive. The patients
present felt it was good that the practice holds their own budget and felt it was
correct that patients are prescribed the cheapest available option. We were asked if
we publish our budget and Dr Bradford stated that we do not publish it ourselves but
that the information is available in the public domain.
Information Sharing
The patients were asked how we might best share information about prescribing
issues with the larger population. It was suggested that an information sheet might
be created giving patients all the possible ways to order their medication plus
information about waste management and that this sheet should be attached to all
patients repeat slip for a 2 months period, this would mean we would reach the
majority of the population who use the service as we issue on average 2 months
supply of medication at a time.
Future Participation in Patient Feedback
The patients present were asked if they would mind being contacted later in the year
with the results of a patient survey which the practice is planning to run. We
explained that part of the survey might include concerns raised from discussions in
our patient focus groups, which we may then want to survey a wider group for their
views. All the patients present were happy for us to ask for their feedback on the
results of this survey.
Outcome/Changes
 Practice to investigate the possibility of adding all the contact details for the
practice including email and fax numbers to the patients repeat slip, so
patients have this information easily at hand to request medication via these
methods.
 Practice to use Newsletter to inform patients of the different methods of
requesting their repeat medication and about waste management.
 Practice to produce a sheet informing patients of the different methods of
requesting their repeat medication and about waste management, which can
be attached to the repeat slip of all patients using the service.
 Practice to feedback to the local pharmacist at the next meeting the problems
patients have encountered when using the RPS scheme.
Summary
All the patients present were thanked for attending and for their input into the
meeting. It was agreed by all present that the overall service offered to patients
using the repeat prescribing processes at the practice was good and that no major
problems were identified. The patients present said that they appreciated being
invited to participate and being given the opportunity to comment on a service which
is important to them. The practice team felt the meeting had been positive and would
try to put the changes discussed in place.
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