Repeat prescribing intervals in Wales to increase from 28 to 56 days

GPs in Wales have been asked to extend repeat prescription intervals as part of reforms aimed at freeing up community pharmacists’ time.

Most patients will see the interval change from April, either at a patient’s annual medication review or over a two-month timeframe, but patients taking certain controlled drugs and patients who need frequent monitoring will be excluded from the prescribing change.

The change in interval follows a review, commissioned by the Welsh government published in March 2021, which found that extending prescribing intervals was an opportunity to save the workload of community pharmacists dealing with repeat prescriptions.

The guidance, jointly published by the Community Pharmacy Wales (CPW) and the British Medical Association’s General Practitioners Committee (GPC) Wales, adds that community pharmacies should work with their local GP practices to discuss and agree a proposed plan for switching patients onto the extended prescription interval.

According to The Pharmaceutical Journal, the Welsh Government responded to the review in January, saying that GPs and pharmacies in Wales currently must write and dispense more prescriptions than in other parts of the UK and suggested that “where clinically appropriate, more patients should be able to have their prescribed medicines dispensed less frequently”.

Data shows that Wales currently trails behind other UK nations, with fewer than 10% of prescriptions being issued for longer than 30 days, whereas in Scotland and Northern Ireland it is more than 40% and around 25% in England.

A spokesperson for the Welsh Government said “It is important to ensure that the unique skills of pharmacists and pharmacy technicians are utilised in supply chains only where they add value, and unnecessary dispensing transactions are minimised.” 

Reduce pressures

As a result, local health boards in Wales are expected to have plans in place to support the implementation of extended prescribing intervals by March 2022.

Cheryl Way, chair of the Royal Pharmaceutical Society’s (RPS’s) Welsh Pharmacy Board, welcomed the changes to prescribing intervals for suitable patients, but added: “It is paramount that any changes must be made alongside the patient, with safety at the centre.

“Together with the proposed changes to reduce the dispensing of non-medicinal products and low-value items, we hope that these changes will reduce pressures on community pharmacy teams and will build more capacity to focus on the clinical elements of the new community pharmacy contract.

“It is important that community pharmacy teams and prescribers work together so that the changes are rolled out in a consistent and patient-centred way across Wales.”

A spokesperson for CPW said “Previous guidance to generally prescribe in 28-day intervals was issued some years ago in response to suggestions that extended periods of treatment resulted in more medicines being wasted.

“However, we have seen no evidence to support this claim.”

In December 2021, the Welsh government announced plans for pharmacies to offer a range of services which will include an emergency contraception service, common minor ailment treatment service, emergency medicine supply service and annual flu vaccination service.