Prescribing Review | Medical Appraisal Scotland

Scottish Medical Appraisal & Revalidation Toolkit Role specific additional considerations Out Of Hours GPs Supporting Information

Prescribing Review for OOH GPs

Although prescribing review and audit are separate topics, many doctors have undertaken a review of their prescribing in the form of an audit. Prescribing reviews need to be undertaken against acknowledged standards, and these are widely available.

Examples are: the OOH organisation's own formulary; local formularies; Health Board prescribing guidelines and SIGN guidelines. You might decide to use an audit of your clinical practice against a published standard in one of these areas.

It is recognised that OOH GPs may have difficulty in reviewing certain types of prescribing when they provide only immediately necessary care (IMC) and are therefore less able to measure the effects of their care - for example with chronic disease management. However there are also important aspects of IMC that can be reviewed: giving a drug to a patient who is unknown to you and about whom you have limited information carries potentially high risks. You should be able to demonstrate that you do this as safely and effectively as possible: this includes being able to justify the use of any drugs which you decide to prescribe.

Prescribing Reviews

A review of:
- the frequency of prescribing in relation to your clinical contacts compared with your peers - "I prescribe X items per 100 consultations, the average in our service is Y and the range is between A and B"
- the frequency with which you prescribe "off formulary" and the reasons for this
A review of 50 acute prescriptions: do they comply with good practice and demonstrate good record keeping?
Management plan proforma: this focusses on your use of a prescribing protocol or guideline with a single patient or group of patients with the same problem (perhaps asthma), to see whether you have followed the good practice guidance
Case report proforma: this allows you to reflect on a patient who presents a difficult prescribing problem that you might have recorded in your log book

Helpful solutions - prescribing data

Ideally you need your personal data from the OOH organisation that you work for. The extent to which you have to extract data personally from the computer system will depend on the willingness of the service to help you. Encourage your employer to help you. They (the service) will ultimately benefit too.

However, there is greater strength in a system of audit in which a number of OOH doctors compare themselves against the mean for the whole service, and it will often be simpler for the service data manager to extract all the data once for a group of doctors than to try to facilitate each of them in turn doing this for individual personal use.

You will find below:

Prescribing review tools with data collection sheets
Reflective template for reviewing the outcome
A worked example from real data

Prescribing Review for OOH GPs

Prescribing Review for OOH GPs

Prescribing Reviews

Helpful solutions - prescribing data

Related Documents