NHS Repeat Dispensing

Question 1

True or False: For each repeat dispensing batch, the practitioner must sign all prescriptions.

Answer 1

False. They only need one signature for the whole batch.

Question 2

When patients are on repeat dispensing, what else does the patient need to do to ensure drug safety?

Answer 2

They should have regular clinical reviews

Question 3

Which prescription template is used for repeat dispensing?

Answer 3

FP10

Question 4

What are the 2 different paper prescriptions?

Answer 4

• Repeatable prescription
• Batch prescriptions

Question 5

Which prescriptions does the doctor sign and what letters are on it?

Answer 5

Repeatable prescription.
RA.

Question 6

Which prescription is used for dispensing and what letters does it have on it?

Answer 6

Batch prescriptions.
RD.

Question 7

Can the prescriptions be amended by hand is there is a mistake?

Answer 7

No, all prescriptions must be rid of and new ones are made.

Question 8

What is written in the signature box for a batch prescription?

Answer 8

Repeat Dispensing: x of y

Question 9

Which patients are suitable for repeat dispensing?

Answer 9

• People with a long-term condition and are stable on medication
• People who use same pharmacy

Question 10

Which patients are not suitable for repeat dispensing?

Answer 10

• Newly diagnosed patients
• People with unstable conditions with changes in medication

Question 11

Patients need to give what before agreeing to repeat dispensing?

Answer 11

Consent for their information to be shared between the surgery and pharmacy.

Question 12

Which medicines cannot be repeat dispensed?

Answer 12

• CD 2 and 3
• ‘when required’
• Non-oral medications
  -> as won’t know how often they will be taking them. Won’t know when they will finish.

Question 13

For prn and non-oral medications can they still be repeat dispensed?

Answer 13

Yes but have to be on a separate prescription.
Will have to discuss with patient if they need more or if they need to stop.

Question 14

Up to how many months can a batch of medicines be prescribed for repeat dispensing?

Answer 14

12 months

Question 15

A repeatable prescription must be dispensed for the first time within how many months?

Answer 15

6 months from the appropriate date.
For CD schedule 4 within 28 days

Question 16

The pharmacy keeps which prescriptions?

Answer 16

Both the RA and the RD.
Patients are encouraged to leave RDs at pharmacy.

Question 17

True or False: The batches must all be dispensed by the same pharmacy that holds the RA.

Answer 17

True

Question 18

All the prescriptions must be dispensed by when?

Answer 18

Within 12 months of the appropriate date

Question 19

Why do you need to check the repeat dispensing prescriptions are clinically safe?

Answer 19

Will have to dispense medications from months ago. (Up to 12 months ago) -> risk

Question 20

If there are any interventions, where must this be recorded?

Answer 20

In the patient’s record

Question 21

What should you ask the patients when assessing the clinical risk of repeat dispensing?

Answer 21

• Are they taking medicine appropriately?
• Any side-effects?
• Any change in condition?
  -Taking any new medicines? (OTC or prescribed)
• Anything they don’t need?
  -> also give date of when they need to collect next supply

Question 22

What should you tell the patients when it is their last batch?

Answer 22

Inform them that it is their last batch. They will have to go back to the surgery for a clinical check before new batch prescribed.

Question 23

To give a patient a written reminder that this is their last batch is a legal requirement or good practice?

Answer 23

Good practice.

Question 24

When is it best to tell a patient if there last prescription is only for 1 month?

Answer 24

Tell them when they come to collect their second to last supply as a patient may have to go through some clinical tests which take time.
- e.g. blood pressure - blood pressure monitoring. May need blood tests and take time to check results.

Question 25

Why is it better to put a ‘prn’ medication on a separate prescription to a prescription with regular medication?

Answer 25

If patient doesn’t want ‘prn’ medication anymore, it is removed from prescription and cannot be dispensed again. If on a separate prescription, if patient needs it later on, it can be dispensed.

Question 26

Why is it difficult if a patient is on repeat dispensing and start a new medication?

Answer 26

It is difficult to add it into the current medication so would be easier to add it in when new batch starts.

Question 27

What happens if medications are discontinued?

Answer 27

GP should notify the pharmacy and they will note it.

Question 28

What is the best thing between a GP and Pharmacist needed for repeat dispensing?

Answer 28

Good communication.

Question 29

When may there be changes to repeat dispensing prescriptions?

Answer 29

- Patient starts/stops medication - Strength of medication changed - Patient in hospital or medication changed by secondary care - Patient not collecting medicines regularly - Patient consistently does not request item

Question 30

When are the prescriptions submitted to the NHSBSA?

Answer 30

- RD should be submitted at the end of the month that it has been dispensed - RA submitted when the whole batch has been dispensed. (Or batches destroyed or RA expired)

Question 31

How is an audit trial kept and what is recorded?

Answer 31

Done on patient’s medication record (PMR) including the date and quantity of each item.

Question 32

For electronic repeat dispensing, how is it different to paper repeat dispensing?

Answer 32

There is no RA. They require an electronic signature for the prescription to be sent so RA not necessary.