Prescriptions Protocol

Patients should be informed how to use the system appropriately. The preferred method is a written request.
Patients will be able to collect the completed prescriptions within 2 working days of their request. If a clinical review is required first, a patient will be informed as soon as possible to allow this review to be arranged. A small supply of the medicine may be prescribed at the discretion of the GP pending this review.
Ideally the prescription should be signed by the patient's usual GP, or by another doctor who is familiar with the clinical situation.
Medicines should only be added to the system when ongoing treatment is required.
Read coded indications for all repeat drugs should be included on the problem summary.
A standard interval of 56 days supply is preferred, but lesser intervals may be appropriate (e.g. hypnotics).
Special dispensing instructions should be included on the printed form and not added afterwards in ink.
Reissuing a new prescription is preferred to altering existing printed versions. This will require deleting the original from the GPASS record.
Regular requests for drugs that are not on repeat prescription should be reviewed and added to the repeat list if appropriate.
The need for ongoing drug therapy should be reassessed at least annually. This review needs to be recorded on GPASS.
Certain classes of medicine are probably not best prescribed without a clinical review of the patient (e.g. Opiates;
Substitute prescribing for drug users; antibiotics; short-term oral steroids).
The majority of medicines should be chosen from the agreed practice drug formulary (Lothian Joint Formulary). This should have the capacity for regular update and review.

Repeat Prescription Administration

Patients can request prescriptions by either ticking items needed on the list of drugs attached to their previous prescription, or filling in a blank prescription request form available beside the reception desk. Both of these should be placed in the box on the wall at the right-hand side of the reception desk. In exceptional circumstances, or if the patient is unable to come down to the health centre eg elderly, disabled etc, they can phone the health centre between 11am and 1pm on the dedicated phone number to reorder. Alternatively, patients may email the practice via the Howden website (www.howdenmedical.co.uk).

The prescription box should be emptied on a regular basis and the items requested ordered on computer. When patients telephone their requests these should be ordered on computer at that time. When prescriptions are processed on the computer the patients are added to the list using the New Task facility. This enables the receptionists to check whether a prescription has been returned to them signed and ready for collection.

Patients should be notified that their prescription will take 2 days to be prepared and can be collected after 4pm.
If anyone requests an urgent prescription they should be reminded that the usual preparation time is 2 working days. A contact telephone number should be taken and notify them that the GP may wish to call them back. If they do not hear from their GP they should call back after 4pm to check if their prescription is ready. The prescription should be printed immediately and marked with a red dot on the top right hand corner of the reorder form and marked “URGENT”. The prescription should then be put up for the doctor to sign, if their own GP is not available that day then the prescription request should be given to the GPs buddy who will deal with it. A message should be recorded on the patients notes on computer stating “Urgent script request” to monitor further requests.

Generally all prescription requests throughout the day are placed on the queue and are all printed at the same time. They should only be stapled on the right hand side, not on the actual prescription. Any that are marked for HC Chemist or Boots should be circled using red pen and either a ‘C’ for HC Chemist or ‘BB’ for Boots should be marked in the top right hand corner of the prescription using red pen. GPs should ensure that any special requests are clearly marked for Chemist etc and attached to any repeat scripts for that patient.

At the end of the day the prescriptions should be sorted into separate piles for each GP. The GP’s number is printed on the bottom of each script. They are then clipped together and distributed to the individual GPs for signing. If a GP is on annual leave or sick leave the next day, their buddy will be responsible for signing their prescriptions. All signed prescriptions are then put in the tray at reception, where they are ticked off on the list and filed in the box for collection (on right hand reception desk), which are filed in alphabetical order, or put in the Boots collection bag (hanging under reception desk) or the health centre pharmacy collection box (on right hand reception desk). If a GP requires to see notes or would like information passed on to the patient these prescriptions are passed to reception staff who will deal with request. If a GP declines a prescription for any reason this is passed to the reception staff who will make a note on the computer using the encounter screen, and contact patient.

The collections box should be checked roughly once a month and any prescriptions over 6 weeks old should be deleted from the computer and the prescription destroyed.

Hospital prescription requests should be scanned and allocated to patient records, then work-flowed to the relevant GP. The GP will then do the prescription (WITHIN 2 WORKING DAYS) and place in basket at front desk when completed.

Direct Suppliers (eg, Homeward, TVM etc) requesting prescriptions may alter the quantity of supplies requested. The prescription desk will print a normal repeat prescription for the items and the GP should change the prescription manually and record the change on computer.

Oxygen scripts need to be printed separately as there are very few pharmacies that supply oxygen in Livingston.

Repeat Prescriptions Mailbox

Protocol for accessing and retrieving email prescription requests

Open Internet Explorer
In the Address bar, type “webmail.howdenmedical.co.uk” and click ‘Go’

The Webmail page will load, and will prompt you for a mailbox name and password:

In the Mailbox box, type the mailbox name.
In the Password box, type the confidential password.
Click ‘Login’

The Inbox page then will open, and you will be able to see any new email messages which have arrived.

To view each individual message, click on the link in the ‘Subject’ column. The page will then change to show the content of the email message.

To print off a paper copy of the message, find the ‘View email as:’ section on the right side of the message screen, and click on the ‘Printable’ link.

The message will appear again in a new smaller window, and shortly afterwards the ‘Print’ box will open. Click on the ‘Print’ button to produce a paper copy.

Once the message has been printed, close down the small message window by clicking on the X in the top right hand corner.

You can then delete the message from the Inbox by clicking on the ‘Delete’ link found just above the message text. The delete confirmation box will appear as below. Click on ‘OK’ to delete the message.

The page will then load the next message content automatically without returning to the Inbox view. You can the repeat the process for the next and subsequent messages.

Once you have printed and deleted the last message, you will return to the now empty Inbox view. Click ‘Logout’ on the right hand side, and you will return to the Logon view. Please then close your browser.