28 Day Prescribing Policy

  1. North East Essex CCG recommends that prescriptions are written for a maximum of 28days.The expectation is that practice policy will reflect this. There are some specific reasons why this may be inappropriate e.g.
  • the prescription is for a course of treatment which is shorter than 28 days e.g. antibiotics
  • the prescription is for a Controlled Drug or a drug liable to misuse when it may be more appropriate to prescribe for a shorter period i.e. daily or weekly scripts, or other small quantities as appropriate in individual circumstances.
  • where there are concerns regarding patient safety small quantities may be appropriate depending in individual clinical circumstances
  • the standard pack for the prescribed medication isfor a longer period e.g. oral contraceptives where most are in 3-month packs
  • the prescription is for a newly initiated medication when a shorter period may be more appropriate i.e.to monitor side effects, patient concordance
  • where monitored dose systems are used to assist patients in managing their medication a 28 day script should be given unless circumstances above apply.
  1. This policy is aimed at reducing medication waste and also ensuring equitable access to medication in times of shortage.
  2. The expectation is all prescriptions will be transmitted to patients nominated pharmacy electronically where appropriate to do so
  3. Where a topical preparation is prescribed the practice and patient should agree the normal amount to be used each monthby thatpatient and prescribe accordingly. Suitable quantities can be found in the BNF for emollients (chapter 13. introduction) and corticosteroid preparations (13.3).
  4. Prescription charges are a national arrangement. The CCG recommends that all practices, pharmacies etc.encourage the use of prescription prepayment certificates for patients who pay for their prescriptions andregularly receive more than one item each month.
  5. Where a patient is stabilised on a medication regimen, and is being monitored and supported in accordance with local and national guidance, then the patient should normally be encouraged to adopt Repeat Dispensing on a 28-day cycle. Pharmacies have a contractual requirement to ascertain concordance with the prescribed regimen and notify the practice of any change or discrepancy.
  6. All practices should have a clear written repeat prescribing policycovering all aspects of the repeat prescribing process including; deletion of items no longer required, synchronisation of medication and exemptions to repeat dispensing e.g. drugs liable to misuse.
  7. Patients who are UK residents who will be moving abroad should only be prescribed for within Department of Health guidance, which is normally to prescribe for no longer than a month when leaving the country, after which arrangements for obtaining medicines should be made in the country of domicile.
  8. GPs may prescribe a maximum of 3 months medication for patients going on extended holidays. For periods longer than three months or for patients moving abroad sufficient medication to allow the patient to access healthcare at their destination should be prescribed (this should not exceed three months supply). Further information can be found at the NHS choices website

Patients who are moving abroad or are travelling for longer than three months would need to de-register with their practice and re-register on their return.

Implementation: April 2011 Reviewed: February 2017

Review: February 2019

Version; 4