Prescribing & Medicines Management
Issue no 2, p1
March/April 2003

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Collaborative practices continue their success

Practices from the 26 PCTs in the first wave of the national collaborative medicines management services programme have shown significant improvements in each of the prescribing measures being monitored, a report on the first year has found. And for the first time, data from measures collected at PCT level also show that they are improving medicines management through the collaborative process.

But according to Richard Seal, programme director at the National Prescribing Centre, Liverpool, one of the most important findings has been the degree of integration of community pharmacists with other members of the primary care team.

"For me the most impressive aspect is not anything that is overt in the report but the team building and improved relationships between community pharmacists and primary care practitioners," he told P&MM.

The figures are also impressive. At the end of the year, prescribers in first-wave practices were writing prescriptions more accurately and with more complete dosage instructions, and fewer repeat items for older patients, while there were fewer patients experiencing problems with their supply of medicines on repeat prescription. In all, 130 practices were selected in July 2001 for a baseline assessment of four prescribing measures at practice level, while five measures were assessed at PCT level. The first year's report shows progress made between October 2001 and October 2002.

Data show that the average number of repeat items prescribed for patients aged over 65 years fell to 6.6 per cent, from 7.1 per cent, while the percentage of requests for inequivalent prescriptions also fell from 55 to 39 per cent. The report found that 100 of the 130 practices had shown improvement in this measure (77 per cent).

The improvement in the proportion of patients who leave the surgery with a prescription for one or more items without specific dosage instructions was more impressive, falling from 22.5 per cent to 7.5 per cent. In all 92 per cent of the practices showed improvements in this measure.

Prescribing and dispensing of repeat items has also improved, the one-year figures show. The percentage of patients who experienced problems with the supply of medicines on repeat prescription fell from 4.4 to 1.1 per cent during the year, with 67 per cent of practices showing an improvement in this measure.

Most of the first wave PCTs were undergoing periods of considerable change. But despite this, most made good progress, the report found. The PCTs recorded a three-fold rise in the proportion of patients in registered care homes who had a documented medication review within the year, from 9.9 to 32 per cent.

The percentage of practices within each PCT that received timely medication information on discharge from their local hospital trusts rose from 36 to 50 per cent, reflecting greater adherence to agreed protocols between primary and secondary care. PCTs also showed improvements from the baseline in the value for money measures selected for study, as well as in outcomes associated with chosen therapeutic areas.

A copy of the report can be downloaded from here