Ms Abigail Cowan, Medicines Optimisation Pharmacist - Midlands and Lancashire CSU introduced her report jointly written with Karen Prior, Chief Officer and Elaine Evans, Project Officer from Healthwatch Wirral. Ms Cowan delivered a presentation that set out the background to, and an update on (including patient feedback) the roll out across Wirral practices of the patient led repeat prescription ordering scheme. The presentation informed that the scheme had been introduced to:

• improve patient safety issues particularly with regards to stockpiling medication;
• ensure patient and GP practice ownership  when ordering medicines;
• improve the communications between GP practices, community pharmacies and patients; and
• reduce the amount of wasted or unused medicines within the NHS.

Ms Cowan’s presentation, supplemented by her report provided information on the aims of the scheme, the roll-out across the Wirral (at the time of report 52 Wirral GP practices were live), the Clinical Commissioning Group (CCG) operational plan and lessons learnt. Ms Cowan informed the Adult Care and Health Overview and Scrutiny Committee that a number of recommendations had been formulated by Healthwatch Wirral as a result of the actions undertaken to date and from patient feedback. Recommendations included:

• Assurances need to be gained from GPs that they are accurately informing patients of the changes or that patients are being informed by the pharmacy.
• Housebound patients should be made explicitly aware of the exemptions by their GP.
• Issues associated with patients accessing the online service should be addressed.
• GP's who only prescribe 1 month supply of medication could consider prescribing 2 months as this may result in a reduction of their workload.
• Adjust patients prescription items, where possible, to ensure that all items run out at the same time thus reducing multiple visits by the patient to the practice to request repeat medication.
• Practices to continue to inform patients that they may not necessarily need to collect their medication from the practice as their pharmacy may continue to collect and deliver medication for patients.
• Continue completing medication reviews to address any issues and to compliment the scheme.
• Continue and improve public engagement as it was evident that some patients were not aware of the new patient led prescription ordering system.
• Encourage patients or their carers to monitor their medication to enable them to be more efficient when requesting a further supply. 
• Consider allowing patients who cannot use the suggested methods of ordering, and may have difficulty in attending the practice, to phone the practice to order medication.

Members noted that engagement and consultation would continue and that although a significant amount of work has been carried out to date to ensure patients were aware of the new scheme, the independent review by Healthwatch Wirral recommendations showed that further work was needed to improve the process and support patient care.

Members questioned Ms Cowan on a variety of points, namely issues arising from implementation of the procedure for controlled drugs and delays arising, inconsistency between the management and delivery of the system between GP practices. Members sought assurances that delays particularly in relation to controlled drugs and life preserving medication e.g. insulin or blood pressure tablets often prescribed to the elderly and most vulnerable patients would be addressed as a matter of priority.

Members requested if data was available for inspection regarding the prescribing of controlled drugs. Mr Simon Banks advised the Overview and Scrutiny Committee that he would speak to Healthwatch Wirral to obtain anonymised data for Member review.

Additional questions were asked of Ms Cowan regarding the financial savings that were expected of the patient led repeat ordering system, and how the estimates had been arrived at. Members also enquired as to whether the system would address the issue of patients stockpiling medication. Ms Cowan and Dr Sue Wells informed that the patient led repeat ordering system provided some additional assurance, but when utilised with closer working with chemists / pharmacists the benefits would assist GPs to monitor patient medication demands more closely. Ms Cowan added that the financial savings expected from the scheme would be redistributed elsewhere within the local health economy.

A Member requested a copy of the guidance / standards provided to GP practices regarding the prescribing of medication.

The Chair thanked Ms Cowan, Dr Wells and Mr Banks for their contributions and information provided via presentation, report and responses to Member questions.

Resolved – that the report be noted.