The Pharmaceutical Journal
Vol 268 No 7194 p543
20 April 2002

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Letters to the Editor

Hospital pharmacy

Lockers could be an area for errors

From Ms J. Szwec, MRPharmS

My colleagues and I were interested to read of the Wirral Hospitals pharmacists' findings that giving medicines from patient lockers leads to fewer medicine administration errors by nurses (PJ, 2 March, p274).

In North Durham, we also operate a system using patient medicines lockers and patients' own drugs and, like the Wirral pharmacists, we believe that administration errors have been reduced when compared with the traditional medicines trolley system.

However, we have encountered problems resulting from nursing staff not completely emptying the lockers when patients are transferred to other wards. Although we are not yet aware of a patient receiving the previous occupant's medicines, this is a potential area for increasing administration errors.

We would be interested to hear if anyone else has found similar problems, and how they were solved.

Julie Szwec
Principal Clinical Pharmacist
University Hospital of North Durham,
Durham DH1 5TW

e-mail Julie.Szwec@ndhcnt.northy.nhs.uk

Let us have electronic prescribing for outpatients

From Mr A. P. Gledhill, MRPharmS

I agree with Noel Baumber (PJ, 6 April, p466) and John Pickup (PJ, 13 April, p495) that the current usage of hospital FP10(HP) prescription forms is unacceptable. Not only are the problems of patient safety important, but the hospital loses control of what its doctors are prescribing and loses sight of the cost implications because the Prescription Pricing Authority cost reports are not available for four to five months. Usage of FP10(HP) forms seems to be on the increase as hospitals focus their limited staff resources on more acutely ill inpatients.

In my dreams I envisage the hospital doctor electronically prescribing from an approved hospital formulary list (using decision support software to check doses, drug interactions etc). The patient is then asked which community pharmacy they would like their prescription electronically transferred to via the NHSnet. A link between the hospital drug database and that used by the community pharmacy using the freely available eDrugID (www.firstdatabank.co.uk) would make the rekeying of data unnecessary. The patient would simply turn up at their local pharmacy with some sort of authorisation form. An electronic record of the prescription would be automatically downloaded into the local health EPR (electronic patient record) which can be accessed at any time by GPs and other authorised NHS staff. Assuming the NHS drug costs are available from the hospital drug database and that the prescription is dispensed in the community then the costs of these prescriptions would be immediately available to the hospital.

The technology to do this is available now but I suspect that we will first have to print a paper copy of the prescription. I would encourage all my hospital colleagues involved with electronic prescribing projects to contact the relevant person in the Department of Health and press for computer printer compatible FP10(HP) forms to be made available and work closely with their software suppliers to introduce electronic prescribing for outpatients.

Andrew Gledhill
Burnley, Lancashire

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