Dr S D Reeves Dr R Kalia Dr C David Dr A Bajracharya
Dr F Pounder Dr K Adkin Dr D Bartholomeuz
SOUTHWELL MEDICAL CENTRE
The Ropewalk. Southwell. Notts NG25 0AL
Prescribing Policy
Written: December 2014
Review Date: by July 2016
Policy.
In order to provide maximum patient safety and to ensure prudence with public funds, the
practice operates a 1 month prescribing policy.
Except in very rare circumstances, only 1 month of medication will be prescribed at a time.
This is in line with the CCG policy at appendix 1.
Appendix 1
Newark and Sherwood CCG 28-Day Prescribing Guideline
Recommendations
A 28-day repeat prescribing interval is broadly recommended; however,
discretion should be used for individual patients or medicines supported by
a rigorous and effective medication review process and good
housekeeping.
Apart from when packs dictate 56 days should be the usual maximum for
repeat quantities and maximum issues should be adjusted accordingly.
Where possible all medicines on the repeat template should be aligned to
the same quantity, whether it is 28 days or 56 days. Co-ordination and
alignment of quantities allows easier identification of compliance issues
and aids medicines optimisation and care planning and avoids the need
for multiple visits to the surgery and repeat requests.
Patients who are stabilised on their medicines and are suitable for longer
prescribing intervals can be considered for repeat dispensing via the
Electronic Prescription service (EPS)
Patient factors should be taken into consideration, bearing in mind
services which are available such community pharmacy delivery schemes,
EPS and the prepayment certificate option for patients requiring more than
4 items in 3 months.
http://www.nhs.uk/NHSEngland/Healthcosts/Pages/PPC.aspx
Medicines on individual practice’s ‘Top 20 by cost’ drugs list, which often
include expensive appliances, specials and unlicensed medicines, should
be a priority for 28 day prescribing.
Prescribers should consider a flexible approach when initiating a medicine;
a shorter interval (7–14 days) may be recommended or appropriate initially
to assess tolerability and compliance.
The National Health Service spends £8 billion a year on prescription
drugs in primary care in England and trying to control the inevitable
wastage of medicines is a primary concern. Nationally, repeat
prescribing accounts for 60-70% by cost and 80% by volume of
prescriptions in the UK (1)
28-day prescription durations have been used as a means to reduce
wastage but the opposing views from patients and health care
professionals make a case for increased dispensing fees, workload and
reduced access.
There is a need to reduce the amount of medicines that are sent away
to be incinerated using a patient centred approach by ensuring that
we have robust repeat prescribing and dispensing systems and
regular quality medication reviews to ensure medicine optimisation
and to minimise the reduced health outcomes that result from people
not taking their medicines as intended
The following additional benefits can be gained from 28 days
prescribing as well as the reduction in medicines incinerated.

Many medicines are now packaged in 28 or 30-day packs and large
quantities in multiple packs can lead to confusion, particularly in the
elderly and result in duplicated doses. Prescribing 28 days ensures that
the patient generally only receives one pack of tablets.

Prescriptions issued on a 28-day basis do not always necessitate an
appointment with a GP, but it does give the patient regular contact with
a healthcare professional where they can raise any problems or
concerns.

A 28 day supply of medication produces a good balance between
patient convenience and risk of wastage for patients with unstable
medical conditions and at risk of admission.
Some medicines are suitable for more than 28 day prescribing,
examples include:
 HRT
 Oral contraceptives
Some medicines should where possible only be prescribed for 28 days,
examples include:
 Controlled drugs
 Drugs prescribed for palliative care




High cost medicines including appliances,
Dressings
Antipsychotic medicines and hypnotics
Medicines prescribed in Care Home
The Department of Health takes the view that prescribing intervals
should be in line with the medically appropriate needs of the patient,
taking into account the need to safeguard NHS resources, patient
convenience, and the dangers of excess drugs in the home (3)
References
1. Improving the use of medicines for better outcomes and reduced
waste. An action plan October 2012
https://www.gov.uk/government/uploads/system/uploads/att
achment_data/file/212837/Improving-the-use-of-medicines-forbetter-outcomes-and-reduced-waste-An-action-plan.pdf
2. All Wales Review and Guidance for Prescribing Intervals February
2013
http://www.awmsg.org/docs/awmsg/medman/All%20Wales%2
0Review%20and%20Guidance%20for%20Prescribing%20Interva
ls.pdf
3. Prescribing in general practice: General practitioners committee. May
2013
http://bma.org.uk/practical-support-at-work/gppractices/prescribing