(Time to read: 8 minutes)

Repeat prescriptions are an integral part of everyday life at GP practices. And it’s no wonder – a late 2017 report written by the University of Bradford’s Dr Duncan Petty has revealed that almost half of the population (43%) are reliant on repeat prescriptions, resulting in over 800 million items of repeat medicines being dispensed each year. This costs the NHS nearly £8bn a year – its biggest cost after staff and almost half its total spend on medicine.

The report goes on to predict that there will be 231 million more repeat prescriptions dispensed each year by 2039 – suggesting there’s a very real need for practices to deal with requests as quickly and efficiently as possible.

Future focus

The report – and the majority of practice managers currently discussing this very topic on the Practice Index Forum – seem to agree that the way forward is to utilise technology and online medicine management. There’s also a push to move patients away from telephone ordering.

One PM commented on the forum thread: “From our audit we discovered we were spending 25 hours a week processing phone requests a big time saving once we changed to online. 18 months later and all is well. It was worth the effort of changing as it is a much more auditable and secure system.”

Another post read: “We stopped taking telephone requests nearly a year ago. We gave notice three months in advance and started encouraging (pushing) people to sign up for online access.”

Substantial benefits

These comments back up the report mentioned above, which outlined how managing repeat prescriptions online saves GPs six hours and 40 minutes a week on paperwork. The financial savings make very interesting reading too. Savings from the Electronic Prescription Service alone over a three-year period are estimated to have been nearly £600m – saving the NHS £137m, general practices £328m, pharmacies £59m and patients £75m.

Dr Duncan Petty, who authored the report, commented: “Repeat prescriptions are a part of many people’s lives and as the population continues to age, many more will be living with long term conditions that require them. Repeat prescriptions currently place a great strain on patients and the NHS, though the NHS is working to improve the efficiency of the prescription ordering process through online ordering and the supply of prescriptions.

“By managing repeat prescriptions online it helps the NHS and makes life easier and more convenient for patients too. NHS staff in general practice and pharmacy will need to support patients with online ordering and continue developing new services to support people on multiple long-term medicines.”

Additional practice benefits include:

• Fewer transcription errors – receiving repeat prescription requests online rather than via the telephone may be easier for staff because it avoids opportunities for error when taking down information over the phone.
• Improved audit trails.
• Fewer phone calls and face-to-face transactions with patients which releases time for reception and administration staff to be deployed on other tasks.
• Free up phone lines for patients who still wish to contact the practice using the telephone.
• Reduce costs by eliminating prescription waste, encouraging patients to avoid stockpiling and to only order the medications that they genuinely need.
• Improve patient satisfaction by providing a more convenient and seamless way to order repeat prescriptions.
• Have fewer visitors to the practice, reducing footfall and shortening queues – giving those patients who do need to visit the practice a better and more efficient experience.

Driving online take-up

The good news for practices is that there’s still a huge chunk of the patient population yet to switch to online ordering. Currently, according to the University of Bradford, only 11% of patients manage their repeat prescriptions online and only 30% are aware they can. That means it should be relatively easy for practices to boost their ratio of online versus paper or phone usage. So how and where do you start your online drive?

Patient benefits

A good place to start is to sell the benefits to patients. According to Dr Petty and his research, patients save an average of 3 hours and 39 minutes a month factoring in time spent arranging appointments, travelling to GPs and pharmacies, sitting in waiting rooms and queuing up.

More than a fifth of people (22%), said they have missed a GP appointment or failed to pick up a prescription due to difficulty making opening hours, getting time off work or medical difficulty getting there. Patients were also found to save an average of £147 a year in transport and associated costs.

Additional benefits for patients include:

• Anywhere, anytime access – 24 hours a day, 7 days a week, at home or abroad using any digital device that can access the internet.
• Reduces visits and phone calls to the practice.
• Able to give permission to an authorised proxy to manage their appointments and prescription ordering.
• Able to check which medication they should be taking and when.
• Verify that the medication they are taking regularly is put on repeat prescription.
• Accessible information on how to take medication safely (including information on side effects) through links to trusted websites (which can also encourage self-care).
• Saves time and money, easy-to-use and eliminates the need to visit the surgery or pay for a telephone call.

Demonstrate the ease

Patients are often scared of new technology, so demonstrate how easy it is to use. Perhaps use your PPG members, practice health champions and/or volunteers to promote online services within the practice.

You could also provide patients with a prescriptions ‘how to’ guide so they understand how to use the system and include some basic visual instructions on your practice website. Ensure staff know how the system works and can answer basic questions.

Promote prescription requests online

If nobody knows, nobody will take up the service, so promote it. Here are a few ideas from NHS England:

• Use promotional materials to create eye-catching, informative displays – place them beside prescription box, check-in screens, reception counter and in consulting rooms.
• Update your website to include a link to the patient log-on screen online services for on the home page – include a banner “Save Time-Do It Online!” at the top of the page so it stands out.
• Include the link on the repeat prescription page.
• Make “order online” the first option on the repeat prescriptions page – describe it as “the easiest, safest and quickest way to order your repeat prescription is online …… register today!”
• Encourage reception/prescription line staff to ask patients “do you use the internet?” If they answer yes, ask for a current email address.
• Encourage and inform of registration process and follow up with emails.
• Ask GPs and nurses to promote online services in consultations – especially with patients who are being issued with repeat prescriptions for the first time. They can professionally vouch for the patient’s identity for transactional services (appointments and repeat prescriptions).
• Change your telephone answer message – “You can order your repeat prescription online …”
• Make online the “default” way to order repeat prescriptions – for instance, automatically provide new patients with online registration details when they register at the practice.
• Consider asking staff to promote online services during face-to-face interactions as well as on the phone. This is very relevant for practice nurses when having consultations with long-term care (LTC) patients.
• Take the opportunity at specialist clinics to discuss and promote online services specifically to this group of patients, e.g. diabetic annual review, COPD, CHD, asthma etc.
• It would be helpful to include online registration information and forms in LTCs appointment reminder letters if they have not already registered. This would help patients to consider this service before their clinic visit.

Use your data

GP practices have a data goldmine at their fingertips – so tap into yours to help you drive online take-up:

• Use system reports to identify all patients on repeat prescriptions who don’t have an active online account, practices can also include validated email address/mobile phone number recorded in the search.
• Use bulk email/text messaging to do targeted promotion with these patients.
• Run a report periodically to pick up any patients new to repeat medications.

Finding balance

Finally, it’s worth remembering that not everybody will be able or willing to go online, so you need to find a balance at your practice that promotes online services but doesn’t exclude certain patients.

As one forum comment pointed out, as well as pushing patients online, other methods need to be available. “As well as the online service we provided a box both inside and outside the surgery for people who would rather leave a paper order (tick list on their FP10 counterfoil),” the practice manager said.

“Certain patients (e.g. blind, frail elderly with nobody to do proxy access) are approved as exceptions on SystmOne by their GP (capsule icon in their demographics box) and can phone. We now have 50% of patients signed up for online. MPS were keen for us to stop taking phone requests and it has released precious receptionist phone time that we need for all the other stuff they now have to do.”

Given the time taken to process phone requests, shifting half of all patients online sounds like a winner to us!

Have you actively promoted online repeat prescription management? What worked for you and what didn’t? Let us know by commenting below or take it to the Practice Index forum here.

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