GP practices within the Swansea, Neath and Port Talbot areas have administrative staff who are integral to repeat prescribing, playing a part in the ordering, generating and issuing prescriptions within their competencies. There is no systematic training or standards for these roles, rather individuals are trained by practices “on the job” using training packs developed by the Health Board Medicines Management Team.
Further to this the Medicine Management Team have developed and rolled out a new Prescribing Clerks Scheme. This aims to enhance and upskill the current clerk workforce within GP practices to deliver improved quality, safety and cost effectiveness of prescribing through systematic enhancements in processes and procedures.
A nominated Prescribing Clerk from each practice attends quarterly training sessions run by the Senior Medicines Management Technicians. Over a duration of 12 months - April 2018 and March 2019 36 educational sessions were delivered, with 75% attendance. Throughout the training sessions the Prescribing Clerks have developed new skills and knowledge to improve the quality and cost effectiveness of prescribing and thus minimising the number of nonclinical queries for GPs e.g. improved systems to tightly control repeat prescription processes by flagging under/over ordering, and thus reducing waste. They are also trained to develop enhanced roles that support further improvements e.g. simple switches, audits/reviews and improving skill mix, this releases pharmacists and technicians to support more clinical work.
At the end of each month the Prescribing Clerks are asked to submit electronically the work which they have undertaken and time taken to complete (the electronic submission form was designed as part of the scheme). The Health Board verifies the forms and authorises payment.
The scheme has been very successful in terms of upskilling staff, supporting the GP workforce and delivering against Health Board prescribing priorities despite having a few challenges such as drug shortages, fluctuating prices and availability of practice staff to attend training sessions.
As a result of learning and feedback we have shifted our focus to workforce development based on practice prescribing need/clerk time and ability thus making prudent repeat prescribing management a core part of everyday work.
