Medicine Wastage

Here are some very useful general points that we would please like to ask everyone to remember! If we all remember the following we can significantly minimise medicines wastage for the NHS.

Repeat Prescriptions

If you are on regular, long term, medication your prescription note will include a tear off section which can be used to order a repeat of your prescription. The tear of slip includes your name, computer reference number, a list of your repeat medication and the planned review dates for these.

Requesting Repeat Medication

You can request your repeat medication by:

• Using apps such as the NHS App
• Putting your ticked repeat prescription slip in the box provided on the reception counter.
• Posting your ticked repeat prescription slip through the letter box which is on the wall to the left of the main doors.
• Send your ticked repeat prescription with a stamped, self addressed envelope, to: Bridge End surgery, Chester-le-Street, Co. Durham, DH3 3SL
• Moving to Electronic Repeat Dispensing of Prescriptions (eRD)

Electronic Repeat Dispensing of Prescriptions (eRD)

If you or someone you care for uses the same medicines regularly, you may be able to benefit from using the NHS Electronic Repeat Dispensing (eRD) service. This means you won’t have to re-order or collect your repeat prescriptions from your GP practice every time you need more medicine.  You may know this as a ‘batch prescription’ or ‘pathfinder prescription’.

STEP 1

Talk to your GP or the person who prescribes your medicines and ask them if you can use Electronic Repeat Dispensing (eRD). Your prescriber will usually be your doctor, practice nurse or practice pharmacist. Your GP or prescriber will then authorise a number of eRD prescriptions. This will be based on your circumstances and clinical need. These eRD prescriptions will then be supplied by your pharmacy at regular intervals.

STEP 2

Collect your first eRD prescription from your pharmacy. You can choose any pharmacy that dispenses NHS prescriptions.

STEP 3

Next time you need more medicines, go back to your pharmacy. Before dispensing the next issue of your prescription, your pharmacy will ask you the following questions:

• Have you seen any health professionals (GP, nurse or hospital doctor), since your last repeat prescription was supplied?
• Have you recently started taking any new medicines – either on prescription or that you have bought over the counter?
• Have you been having any problems with your medication or experiencing any side effects?
• Are there any items on your repeat prescription that you don’t need this month?

If you don’t need all of the medicines on your prescription, let the pharmacy staff know, so that they only supply the medicines you need. This will help to reduce waste and save the NHS money.

STEP 4

When your pharmacy supplies your final prescription, they will advise you to contact your GP practice to arrange for your medication to be reviewed and if it is clinically appropriate to issue another eRD prescription. Your doctor or practice nurse may want you to make an appointment to see them before they will authorise more eRD prescriptions.

Prescriptions will be ready in two working days.

On rare occasions, the doctor may decide not to issue your prescription. This may be because it seems to be ordered too early - we are asked to minimise the chance of wastage - or the doctor may want to discuss the request with you. A note will be attached to your script or the receptionist will be able to advise you on the reason. If requested online, there will be a reason on the reply form. 

Collection Service

There are a number of local pharmacies in and around Chester-le-Street that offer a nomination service for prescriptions. If you tell our reception staff which pharmacy you use we will add that to your record and your prescription will be sent directly to them. You can then collect your medication from them.

Patients Travelling Overseas

'Prescribing Dilemmas: Advice for prescribers in County Durham and Darlington April 2013' states:

4.1 NHS patients travelling for three months or less

Medication required for a pre-existing condition should be provided in sufficient quantity to cover the journey and allow the patient to obtain medical attention abroad. If the patient is returning within the timescale of a normal prescription (usually one and no more than three months) then this should be issued providing it is clinically appropriate.

4.2 NHS patients living or travelling abroad for more than three months of the year

It is not a responsibility of the NHS to provide health services outside of the UK. If a person will be abroad for three months or more then the patient is only entitled to a sufficient supply of regular medication to get to the destination and find an alternative supply of that medication.

For longer visits abroad, the patient should be advised to register with a local doctor for continuing medication. It is wise for the patient to check with the manufacturer that medicines required are available in the country being visited. It is also worth advising that medicines can be purchased without a prescription from pharmacies in some countries.

Prescriptions Charges and Exemptions

Extensive exemption and remission arrangements protect those likely to have difficulty in paying charges (NHS prescription and dental charges, optical and hospital travel costs).

The NHS prescription charge is a flat-rate amount which successive Governments have thought it reasonable to charge for those who can afford to pay for their medicines. Prescription prepayment certificates (PPCs) offer real savings for people who need extensive medication.

NHS charges

These charges apply in England only. In Northern Ireland, Scotland and Wales prescriptions are free of charge.

• Prescription (per item): £9.65
• 12-month prepayment certificate (PPC): £111.60
• 3-month PPC: £31.25
• a 12-month PPC for hormone replacement therapy (HRT) only is £19.30

If you will have to pay for four or more prescription items in three months, or more than 15 items in 12 months, you may find it cheaper to buy a PPC.

• Telephone advice and order line 0845 850 0030
• General Public - Buy or Renew a PPC On-line

There is further information about prescription exemptions and fees on the NHS website

Below are some useful points to remember when you are thinking about your medication

Please let your GP or Pharmacist know if you’ve stopped taking any of your medicines

Check what medicines you still have at home before re-ordering

Discuss your medication with your GP or Pharmacist on a regular basis

Think carefully before ticking all the boxes on your repeat prescription forms, tick those you really need

If you don’t need the medicine please don’t order it! If you need the medicine in the future you can still request it.

If you need to go into hospital, please remember to take all your medicines with you in a clearly marked bag.

Please also remember that your medicines are prescribed only for you; it’s not safe to share them with anyone else.

Even if you never open them, once medicines have left the Pharmacy, they cannot be recycled or used by anyone else.

Please bring your unused medicines to the Pharmacy for safe disposal. If your medicines change, return old medicines to the pharmacy for safe disposal to avoid mixing them up with your new medicines

NEVER dispose of your unused or unwanted medicines down the toilet

Don’t stockpile medication – it is a safety risk for children and others who might take them

Store medicines in an appropriate place out of reach of children

Once your medications are due for collection; please try to collect them with reasonable promptness. This avoids build-up of uncollected medicines in the Pharmacy.

Travelling out of the country for less  than 3 months
For patients who inform us they will be out of the country for less than 3 months, we will provide sufficient medicines for an existing condition (e.g. asthma, diabetes…) for the period while the patient is away where it is safe to do so.  Drugs that require frequent monitoring may not be prescribed where there are safety concerns.  1 months supply only will be issued for drugs normally available over the counter, such as paracetamol.

Travelling out of the country for more than 3 months
Patients who inform us they will be leaving the country for more than 3 months will be prescribed sufficient medication to enable them to make alternative arrangements at their destination (up to 3 months supply where safe to do so).

Patients and relatives should not seek medication for themselves while they are abroad as this constitutes NHS fraud.

Prescriptions for medicines in case of illness while abroad.

GPs will only prescribe NHS prescriptions in this case for exacerbations of pre-existing illnesses; E.g. antibiotics for patients who have frequent infections secondary to an underlying lung condition.

GPs may provide private prescriptions if it is clinically appropriate and they can be self-administered safely without medical assessment while abroad. These prescriptions are not free.

Patients should be aware that some drugs commonly prescribed in the UK may be illegal in certain countries and you should check with that countries embassy before you travel.

We strongly recommend you check - www.gov.uk/travelling-controlled-drugs

Green Prescribing Project

At Bridge End we are trying to deliver Green Prescribing and we have compiled a short video in which Dr Brown explains what we have done and why and will upload it here but we have a link available 

 Presentation-20240124_144725-Meeting Recording.mp4

What is Green Impact for Health?

Green Impact for Health is a tried and tested formula developed by the RCGP and NUS/SOS. In 2020/21 it was by used by over 1000 General Practices across the country.

Put simply it is an online DIY guide to help you make General Practice more environmentally sustainable. Green Impact for Health provides guidance about the small changes that should improve the environmental sustainability and is something that Bridge End is striving to deliver.