Patient-centred improvement to repeat prescribing using the Always Event concept

Repeat prescriptions are prescriptions issued to a patient for a second or subsequent time without requiring a consultation with a doctor. Repeat prescribing is common and an efficient system is necessary to deliver a high-quality service. Always Events can be used to drive patient-centred improvements in healthcare delivery. Our aim was to use the Always Event concept to improve our repeat prescribing system. This quality improvement project was carried out in a deprived, inner-city general practice setting in Glasgow, UK. 51 patients taking repeat medications completed short questionnaires, and the Always Event ‘Repeat prescriptions should be ready and available to collect’ was generated. We used the Plan-Do-Study-Act cycles to elucidate how our system could be improved and check if our intervention was effective. Over a 3-day period in July 2016, 269 out of 292 prescriptions (92.1%) were ready. We mapped out the repeat prescribing process and discovered that sometimes reception staff graded a request as inappropriate, for example, requested too early, and these requests were therefore not processed. Patients would then attend to collect a prescription that was not there. This was both inconvenient for the patient and time-consuming for the reception staff to investigate the reason. Our system was changed so that any request that was not being processed was recorded and the patient informed. In September 260 out of 267 (97.4%) prescriptions were ready, in November 350 out of 364 (96.2%), and in February 2017 314 out of 323 (97.2%) were ready. In conclusion, the Always Event approach allowed us to elicit important feedback from patients to identify a weakness in our repeat prescribing system, which was simple to rectify and led to an improved, more efficient service.