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NHS 'wastes pounds 60m on prescriptions': Better monitoring of long-term treatment urged

Judy Jones,Health Services Correspondent
Tuesday 10 August 1993 23:02 BST
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DOCTORS are often failing to monitor the needs of patients on long-term medication and up to pounds 60m of prescription drugs may be wasted each year as a result, a government spending watchdog warns today.

About 400 million prescriptions were issued in England last year, according to the National Audit Office, at an estimated cost of pounds 2.6bn. Two in every three prescriptions were 'repeats', made without the need for a consultation with the doctor.

Community health council surveys in west Birmingham and Oxfordshire found procedures for repeat prescriptions varied widely between GP surgeries. 'Some were designed to meet the needs of a busy surgery, while others were tailored to suit the circumstances of individual patients,' the NAO report says.

Researchers at Manchester University estimated this year that up to pounds 60m of drugs dispensed in England could be wasted annually. In a study for the Department of Health, they found that one in five repeat prescriptions was for more than one item. One-fifth of these did not have a common number of days' treatment for all the items. About 14 per cent of the value of the drugs on multiple prescriptions appeared to be excess to requirements, when compared to the shortest duration item, the researchers found.

Moreover, the South East Thames regional pharmaceutical adviser told the NAO that there had been many occasions when a patient's treatment had been altered, but information about the new drug or dose had not been entered into the repeat prescribing system. 'The result was that subsequent repeat prescriptions were generated for the wrong dose or drug.'

The lapse was particularly likely to happen following a home visit by the general practitioner, or when a hospital consultant had changed the prescription.

The NHS management executive has made targeting of repeat prescriptions a priority - but today's report highlights the need for further action by health authorities and GPs to ensure that they are appropriate and efficient.

But the British Medical Association pointed out that the Manchester research mentioned by the NAO did not blame GPs for the wastage. It was caused by the way drugs were packaged, not unnecessary repeat prescriptions. The NAO concludes that repeat prescriptions are a good idea, properly used, but patients' health could be put at risk unless prescriptions were reviewed regularly.

The report recommended Family Health Service Authorities should set out guidance on when repeat prescriptions should be issued; ask doctors to examine how often they issue repeats or review the condition of patients and the type of drugs prescribed. Doctors are asked to identify patients who have been on prolonged medication and invite them for a consultation.

Repeat Prescribing by General Medical Practitioners in England; HC 897; HMSO; pounds 6.80.

Price cuts, page 21

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