Having identified an area of practice where change may be required, you need to review this area and identify where and how to obtain the necessary data.
Your review should consist of an analysis of the current situation, and comments on any areas where change would be appropriate. You may need to look at your prescribing data in detail.
Details of all NHS prescriptions dispensed in Scotland are stored on a central database called PRISMS (PRescribing Information SysteM for Scotland) which is maintained by Public Health Scotland. More information (and access) is available on their website: https://publichealthscotland.scot/our-areas-of-work/acute-and-emergency-services/prescribing-data/prisms/
Remember this data reflects prescriptions that are dispensed, and this will vary from what is actually prescribed. Accuracy also depends upon your local policy for allocating prescriptions. (Does the patient's usual doctor, or registered doctor, take responsibility for repeat prescriptions, or acute prescriptions?)
Some search facilities on workplace computer systems can provide a limited analysis of prescribing, and for some questions this may be entirely adequate. Of course it will only reflect drugs prescribed, not drugs dispensed; and will not offer the cost-benefit analysis. On the other hand it can provide you with the names of individual patients for whom you have prescribed a drug and allow you to audit clinical indications and the outcome.
Sessional or Out-Of-Hours doctors will not have access to personal data within the computerised prescribing databases. However, it would be possible to reflect upon a manually collected series, for instance the analgesics or antibiotics prescribed in your last 20 surgeries. The simplest way to do this is to retain and annotate the prescription counterfoils (just remember to dispose of them as confidential waste after use).
Additional value could be added by working in a small study group with other sessional colleagues to compare your results.
Alternatively you may wish to analyse prescribing data for your organisation as a whole, and this would be acceptable provided that the interpretation had a personal impact and relevance.
This page was last updated on: 30/10/2024
