Cluster page — medicines optimisation
Repeat prescribing optimisation
The opportunity
Why repeat prescribing is the highest-ROI process in MO
Repeat prescribing accounts for roughly three-quarters of all primary care prescriptions and is, in most practices, the single largest source of GP administrative workload. The traditional GP-authorisation model is also a prescribing safety risk: it concentrates a high-volume, low-attention task on the clinician with the least time to perform monitoring currency checks.
Moving repeat authorisation to a clinical pharmacist under a defined scope of practice — supported by eRD adoption for stable long-term condition patients, synchronisation to reduce issue volume, and a pharmacy-technician-run query line — typically releases 4–6 GP hours per week per 10,000 patients while measurably improving monitoring currency and reducing prescribing incidents.
Redesign components
What a mature pharmacist-led repeat model includes
- Defined pharmacist scope of practice — drug classes in/out, monitoring requirements
- eRD adoption pathway — identify eligible LTC patients, opt-in process
- Synchronisation — align all repeat items to a single 28- or 56-day cycle
- Pharmacy technician query line — handle straightforward queries, refer clinical to pharmacist
- Monitoring currency hard-stops — no re-issue without current INR/U&E/HbA1c etc.
- Annual review trigger — automatic flag to SMR when due
- Prescribing safety SEA integration — every incident reviewed at PCN level
Repeat KPIs
Performance benchmarks
Frequently asked questions
Repeat prescribing — FAQs
Why redesign repeat prescribing?+
Repeat prescribing accounts for ~75% of all primary care prescriptions and is the single largest source of practice prescribing workload. Moving the authorisation layer from GP to clinical pharmacist (under defined scope) typically releases 4–6 GP hours per week per 10,000 patients and improves prescribing safety simultaneously.
What is electronic Repeat Dispensing (eRD)?+
eRD allows a single prescription to authorise multiple dispensings over up to 12 months, with the community pharmacy releasing each issue. It is appropriate for stable long-term condition patients on unchanged regimens and significantly reduces the per-prescription administrative load.
How does pharmacist-led repeat authorisation work safely?+
Through a defined scope of practice (which drug classes, which patient cohorts, which exclusions), pharmacist IP qualification or strong delegation framework for non-IP, monitoring currency checks built into the workflow, and SEA-driven continuous improvement.
What KPIs measure repeat prescribing performance?+
Prescription turnaround time, eRD uptake percentage of eligible patients, prescribing query volume, return rate (issues re-issued without authorisation), and prescribing safety incident rate associated with the repeat process.
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