Prescriptions Flashcards
Legal requirements on an FP10
Name and address of patient
The prescriber (their details) including their name, qualification (bmbs) and registration number
Date it was prescribed (legal requirement)
six months on the date of prescribing, if later then it cannot be dispensed if not breaking the terms of contract
Date of birth of the patient if they are under 12 (or age, both are ideal)
Prescribers signature
Name of the surgery the doctor or prescriber is working at
Terms of service requirements on an FP10
Drug form, quantity and strength
Terms of service issues
Missing strength OR form of a drug:
If this drug is only available in one strength or form, dispense it and endorse what was given.
If more than one strength or form exists, call the prescriber to ascertain form and quantity required and endorse “PC” (initial and date).
Missing quantity for a drug:
Call the prescriber, add quantity required and endorse “PC” (initial and date).
If cannot call the prescriber, supply enough for 5 days of treatment only and endorse “PNC”.
Missing strength AND quantity for a drug:
Call the prescriber, add strength and quantity required and endorse “PC” (initial and date).
If cannot call the prescriber, supply enough for 5 days of treatment only and endorse “PNC”.
Terms of service issues
N.B. PC/PNC endorsement is ONLY required if the terms of service change has been made OVER THE PHONE!!
If the changes have been made in person then DO NOT give a PC/PNC endorsement – you will be penalised in the OSCE if you incorrectly provide one
You ALWAYS need to provide an endorsement for payment regardless of whether changes have been made over the phone or in person – NHSBSA will not know what to pay you for if it has not been provided – you will lose 2 marks for not providing a correct endorsement in the OSCE
What is EPS?
Allows prescribers to send prescriptions electronically to a dispenser (e.g. a pharmacy) of the patient’s choice – Nomination
Dispenser will then send the electronic prescription to the pricing authority for payment
Benefits of EPS
Electronic prescriptions contain the patient’s information, no need to type this into your dispensing system – reduce errors
Prescribers use a standardised drug dictionary to complete electronic prescriptions – improves prescription accuracy and reduces the risk of the patient receiving the wrong medication
Reduction of reimbursement errors
Less risk of duplicate prescriptions because electronic prescriptions can’t be lost
No need to send and collect paper prescriptions to and from GP practices
Receiving the electronic prescription in advance of the patient arrival means you have time to sort out of stock items and reducing your waiting times
Notes can be added to electronic prescriptions which allow messages from prescribers to be passed to patients
Tokens
Anything on paper with a bar code (the electronic prescription is sat on the NHS spine)
Two types of token:
Prescription token
Dispensing token
Prescription tokens
Printed by the prescriber at the GP surgery on green stationary
Only a copy of the electronic prescription and should never be signed by the authorising prescriber – can only be amended or cancelled electronically
Will always have the name and address of the nominated pharmacy printed on it – the patient knows which pharmacy to take it to
Can be scanned at the pharmacy to retrieve the prescription
Dispensing tokens
Are printed by the pharmacy on white stationary
Should be printed when the patient needs to sign for payment or exemption declaration purposes. No signature required if patient is age exempt
Should be printed when a patient needs to visit another pharmacy to collect their medication. Must return the prescription to the NHS spine for the next pharmacy to be able to retrieve it
Not seen by the pricing authority
2 ways to access electronic prescription
There are 2 ways to access an electronic prescription:
Do a download to retrieve all electronic prescriptions from the NHS spine which have been sent from GP surgeries
Scan the prescription token barcode or manually type in the number on the barcode
Finding electronic prescriptions
Do a routine prescription download
Use the EPS Prescription Tracker and search by NHS number
Cancelling electronic prescriptions
A prescriber can cancel a whole prescription or individual items right up until it is dispensed to a patient
The reason for cancellation must be recorded and it is the prescriber’s responsibility to inform the patient
Smartcards
Clinical and personal information can only be accessed by those who have a valid reason to do so
Needed to access electronic prescriptions, Summary Care Records and EPS tracker
Doses and instructions
AC – before food
BD – twice a day
OD – each day
OM – in the morning
ON – at night
PC - after food
PRN – when required
QDS – four times a day
QQH – every four hours
stat – immediately
TDS or TID – three times a day
Quantities on prescriptions
The quantity is sometimes stated as x/12 where x is the number of months supply (there are 12 months in a year)
Sometimes the duration of treatment is expressed as x/7 where x is the number of days treatment (there are 7 days in a week)
Example 1
Atenolol 50mg one daily for 3/12
Quantity = 84 = 3 months supply
Example 2
Furosemide 40mg one daily for 14/7
Quantity = 14
Splitting blisters – pack sizes!!
