The Moat House Surgery
Action Taken
The Moat House Surgery requested changes to the EMIS prescribing process to flag early prescription requests and developed a pop-up box alerting staff to prescriptions issued less than 30 days prior. They also implemented a 'Controlled Drug Monitoring' template and process for medication reviews. (AI summary)
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Dear Crawford, Re: Mrs Hayley Denise SHEEHAN (Deceased) Regulation 28 Report to Prevent Future Deaths Further to your letter dated 1st August regarding Regulation 28 Report to Prevent Future Deaths and that 'consideration should be given to introducing more safeguards to ensure that early requests for repeat prescriptions are identified and drawn to the attention of a GP. This should include giving consideration to whether the relevant software can be adapted to automatically identify early prescription requests. A meeting was held at the Moat House Surgery attended by the GP Partners, Practice Manager, IT Manager and the lead clinical administrator on 17th August 2017. Following discussion at the meeting an e-mail was sent to EMIS Health, the provider of our clinical software system EMIS Web, requesting changes to the EMIS prescribing process, so that early prescription requests are 'flagged up' enclose copies of the correspondence_ In the meantime, our IT Manager has developed a pop-up box within patients' notes which alerts the issuer of a prescription to the fact that a previous prescription had been issued less than 30 previously. The pop-up box can be configured to an early request for all drugs, a particular or drug ingredient: It is currently configured to use a predefined list of products with controlled drug ingredients The 'safety net' feature added to the EMIS Web system is a template called 'Controlled Monitoring' , which will include all patients who are on Tramadol and opioid-based medication and will be grouped according to their registered GP, A search will be carried out on the 1st Monday of every month and the GPs concerned will be advised to carry out a medication Welsltzo: www? themoalhhousosurgery.co. Email; support@themoathousesurgery co.uk Ms days flag drug; Drug
review; The search will list all opioid products and Tramadol Hydrochloride products issued in the last month where a medication review was not performed in the last three months GP'$ can use the template to find out how many medications been issued to a particular patient and will set a date for the next medication review, The Clinical Administrators can see the pop-up warning and will also be able to see the last medication review date in the Medication screen and will be able tox Decline the request Bring to the attention of the relevant GP that medications are being requested too early Bring to the attention ofthe relevant GP if there are concerns that patients may be stockpiling medication or using them in excess of the prescribed dose. We are addressing the concerns raised by You, thereby providing improved safeguarding for our patients against any further serious incidents resulting from accidental overdose of medication_
review; The search will list all opioid products and Tramadol Hydrochloride products issued in the last month where a medication review was not performed in the last three months GP'$ can use the template to find out how many medications been issued to a particular patient and will set a date for the next medication review, The Clinical Administrators can see the pop-up warning and will also be able to see the last medication review date in the Medication screen and will be able tox Decline the request Bring to the attention of the relevant GP that medications are being requested too early Bring to the attention ofthe relevant GP if there are concerns that patients may be stockpiling medication or using them in excess of the prescribed dose. We are addressing the concerns raised by You, thereby providing improved safeguarding for our patients against any further serious incidents resulting from accidental overdose of medication_