Pharmacy’s experience of the repeat dispensing service

Community pharmacy teams in England have been required to advise appropriate patients about the benefits of the repeat dispensing service since March. How are they getting on? PSNC shares the experiences of a group of pharmacists about the practicalities of the scheme

Why the service is a good idea

There are advantages – to patients, GPs and to the pharmacy – from enrolling patients onto the repeat dispensing service. Here’s what one group of pharmacists suggests are the main pluses, together with their suggestions for making things run smoothly in your pharmacy.

You can more easily manage your dispensary ‘You can prepare the medicines in advance, so it’s good for time and stock management,’ says Tahira Sagheer, pharmacist at Geloo Brothers Pharmacy in Blackburn. And Lorna Harwood, pharmacist at Langho Pharmacy in Blackburn, acknowledges that some pharmacy contractors are worried about the service creating more work, but says ‘it’s quite straightforward once it’s been set up’. TOP TIP: The pharmacists suggest making a note of when repeat dispensing patients are next due to come into your pharmacy and adding their items to your stock orders the week before. This way, you know that you have what they need before they come in to collect.

Use the Electronic Prescription Service (EPS) to make working easier ‘Doing this on EPS is even easier, because you can see who’s coming,’ says Ms Harwood, ‘and it’s much more efficient.’ And Paul Bisby, pharmacist at Richardson Pharmacy in Preston, highlights the reduction in paperwork for repeat dispensing patients when using EPS. TOP TIP: The pharmacists suggest encouraging your local GP practices and their patients to sign up to EPS Release 2, which will allow for instant transfer of the repeat prescription data from the practice to your pharmacy. Using EPS will also allow you to pull down the next electronic repeat prescription before the patient arrives, again allowing you to prepare their medicines in advance.

Appropriate patients are likely to be receptive to the idea Patients keep renewing their repeats, so they must be happy, says Mr Bisby. ‘It’s saving both their time and their GPs’ time, so they will go with it,’ he comments. Mohmed Moosa, pharmacist at Livesey Pharmacy in Blackburn, agrees. ‘Sometimes patients need the system explained to them or for us to write something for them to give to the GP practice to ask for it to be set up, but they really like the convenience, he says. TOP TIP: The pharmacists suggest using leaflets to initiate conversations with patients who might be interested in the service. You can also talk about how the process prevents the need for frequent appointments with their GP. All they need to do is sign a consent form so their GP can share information about their medicines with you, their local pharmacist.

Most GP practices are keen on it Ms Sagheer has had good feedback from GPs. Mr Bisby says the surgeries ‘have really taken to it’ in his area, as repeat dispensing cuts down on the GP receptionist’s time. TOP TIP: The pharmacists suggest working with your local GP practices to sign patients up. You can talk to GPs about the reduction in their workload due to fewer appointments, allowing them more time for other patients.

How to do it

The pharmacists suggest a range of points that they say will be useful for other pharmacies to take up.

Look at your prescriptions – if you see repeated items, then speak to the patients about it Mr Moosa provides leaflets and other information about the repeat dispensing scheme to patients he sees coming back for the same items again and again. He explains that it’s important to be active in relaying the message. TOP TIP: The pharmacists suggest using your patient knowledge to approach your ‘regulars’ as they are the ones most likely to be suitable candidates for repeat dispensing and would benefit most from the service.

Be proactive Mr Bisby has been busy identifying patients from his PMR system and listening out for patients talking about wanting an easier way to manage their prescription collections. Putting leaflets in the bags is a great way to start conversations about repeat dispensing, says Mr Moosa. TOP TIP: The pharmacists suggest using the data on your PMR system to help you identify appropriate patients. You will be surprised by the number of patients you are able to discuss the service with.

You need a good method of recording Mr Bisby has created his own in-house template, which contains the key questions the team need to ask patients.TOP TIP: The pharmacists suggest finding your own way of keeping track of the paperwork and incorporating this into your repeat dispensing SOP, so the whole pharmacy team knows what to record and where to file it.

If staff from the pharmacy and GP practice come together and talk about it, it works well All the pharmacists PSNC spoke to highlighted the importance of maintaining a good relationship with GP practice staff so vital communication can take place where necessary. Ms Sagheer says her team have sent letters to all GP practices in the area to make them aware of the service. ‘GPs need to recognise the pharmacy team’s recommendations,’ says Mr Moosa, and that requires working with the GP practice staff. Alastair Buxton, head of NHS Services at PSNC, says: ‘Although pharmacies can of course identify suitable patients from their own records, we would also encourage them to talk to local GP practices about the service. As practices begin using EPS Release 2, it is likely to make sense for the majority of their patients who are using electronic prescriptions, particularly those who are already on managed repeats, to move to this service, and practices could help to signpost patients directly to it.’ TOP TIP: The pharmacists suggest taking the time to discuss with GP practice staff how the process of signing up patients will work, who will be responsible for what and what records will be kept. This is also a good opportunity to talk through and resolve any current issues with communication on the repeat dispensing service. It is important to ensure both healthcare teams are on the same page, so the process flows well.

What patients need to know:

  • Patients must be made aware that they are free to choose whichever NHS community pharmacy they want to provide the repeat dispensing service. Your regular patients are highly likely to pick you for familiarity.
  • Remind your patients that they can still speak to you as a healthcare professional and raise any concerns they may have about their medicines, without needing to make an appointment.
  • Reassure your patients that you can hold on to all their repeat prescriptions, so they don’t need to worry about misplacing them or remembering to bring them in each time.
  • Make sure your patients know that this is an NHS-funded service, so is available to them free of charge. (Note: unless they are exempt, ensure patients are aware that they will still need to pay the NHS prescription charge for their medicines.)
  • You can find further support and guidance, including patient leaflets and frequently asked questions, on the PSNC website: www.psnc.org.uk/repeatdispensing

Problem solving

Pharmacist Lorna Harwood suggests solutions for some potential problems:

What if I’m faced with reluctant GPs? Ms Harwood recommends getting the patients to ask to join the scheme. ‘Patients have the power and are more likely to influence the practice.’

What if it’s not right for my patients? The team were having problems with one couple who just couldn’t get their heads around it, but she learnt a useful lesson from this. ‘You have to be selective on patients you try it with.’

What if something goes wrong? She recalls one GP who kept trying to change an electronic repeatable prescription, which caused a bit of hassle, but her team were quick to pick this up and explained how the process works to him. This highlights the importance of GP engagement and involvement in the service. Good communication between community pharmacy teams and GP practice staff is essential.

If the number of patients using repeat dispensing is to be significantly increased, pharmacy teams will need to approach more patients than they may have done previously about the repeat dispensing service. Here are some things you may want to consider:

The patient’s individual circumstances Different patients may respond better to different approaches due to their age, background or current situation. Keep the messages simple and straightforward when explaining the service to patients and emphasise the benefits to them.

Timing is everything The day of the week, time of day, how busy the pharmacy is and the perceived emotion of the patient (ie do they look stressed and in a hurry?) will play a part in deciding how and when to approach the subject. If a patient is in a rush today, put a leaflet in their dispensing bag and chat with them next time they visit the pharmacy.

Staff training Patients may ask questions, so staff should have a full understanding of how the service works.

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