7/28 Day Prescribing Letter

Prescribing periodicity

Representatives from NHS Sheffield CCG, Community Pharmacy Sheffield, the Local Medical Committee and Sheffield City Council recognise that weekly prescriptions are frequently being requested by pharmacies when dispensing medication into multi-compartment compliance aids. Both the pharmacist and the prescriber have a shared responsibility under the Equality Act to make reasonable adjustments in order to meet the needs of the disabled patient. This may include the issue of 7 day prescriptions. A suitable assessment tool has been agreed and can be used to help identify suitable support to meet the needs of these patients.

There are other occasions where 7 day prescriptions are considered appropriate and the prescribing periodicity should be in line with the clinical needs of the patient such as those known to be at risk of self-harm, those having unstable medication regimes with frequent changes or those patients with limited cognitive ability.

The representatives from NHS Sheffield CCG, Community Pharmacy Sheffield, the Local Medical Committee and Sheffield City Council have agreed on a unified position on prescribing periodicity as stated in a letter dated March 2018. This replaces one agreed in August 2011. They also support the use of the assessment tool.

Although there are some patients who may benefit from having their medication supplied in a Monitored Dosage System it should not be assumed that such systems will solve adherence issues. The suitability of the compliance aid should always be assessed and pharmacists are advised to be read the recent paper published by the Royal Pharmaceutical Society:-

Improving Patient Outcomes – The better use of multi-compartment compliance aids (www.rpharms.com/unsecure-support-resources/improving-patient-outcomes-through-the-better-use-of-mcas.asp)

Many care homes are known to request that their residents’ medication be supplied in compliance aids. There is little evidence that this improves patient outcomes and in fact is done for the convenience of care staff. Pharmacists supplying care homes with MDS packs should be aware of the important paper on the subject published by the Royal Pharmaceutical Society Scotland:-

Improving Pharmaceutical Care in Care Homes (March 2012) http://www.rpharms.com/promoting-pharmacy-pdfs/rpscarehomereportfinalmarch2012.pdf

A key recommendation of this paper states:- 

“11. Due to concerns around safety, patient empowerment, effectiveness and efficiency, the RPS calls for the supply of medicines in original packs in care homes to be promoted as standard. This will require support at national and local level, agreement from care home providers and pharmacy contractors supported by robust systems, staff training and evaluation.”

Last updated on 06/09/2021 by KerryWade