28 Day Prescribing Policy

The NHS recognises that a 28-day repeat prescribing interval makes the best possible balance between patient convenience, good medical practice and minimal drug wastage.

The British Medical Association notes that “Prescribing intervals should be in line with the medically appropriate needs of the patient, taking into account the need to safeguard NHS resources, patient convenience, and the dangers of excess drugs in the home.”

The benefits of 28-day prescribing include:

• Reducing the amount of medicine which is currently wasted when your doctor stops or changes your medicine.
• Reducing the potential for error when your medication is changed in the middle of supply.
• Increased safety as you will not have multiple containers of the same medicine meaning it is likely to reduce the number of mistakes made by, for example, elderly patients, and it will also reduce the risk of potential poisoning of young children.
• Many medicines are supplied in 28-day packs, allowing you to check that you have taken your medication each day. You will start and finish the container of each medicine on the same day of the week, meaning it will be easier for your doctor to review all of the repeat medicines you are taking and to see when you have not ordered your medicines.
• Financial losses due to medicines waste represent a direct loss to patient care. Since 28-day prescribing reduces medicines waste, this in turn has a positive impact on patient care.

Studies in the UK and abroad have shown significant savings and a reduction in waste with 28-day prescribing.

Due to the current pandemic crisis and ongoing issues with the NHS supply chain, we are implementing 28 day prescribing as per guidance from the Department of Health. NICE Guidelines support 28 day prescribing and recommend that medicines are prescribed for no more than 30 days (prescribing larger quantities puts the supply chain at risk).

Your doctor will provide you with a prescription for an interval that they believe to be most clinically appropriate for you, taking into account all sort of issues, such as how stable your condition is, how long they expect you to take the medicine for, any side-effects you may experience, whether or not your medicine may change in the future, and any monitoring required. For some patients on certain medicines at a stable dose (e.g. contraceptives & HRT), your doctor may decide it is appropriate to issue prescriptions for prescribing intervals longer than 28 days and for medicines that are taken “as required” or for creams and certain inhalers your medicines may only be available on the normal repeat basis when you will make the request in the usual way in writing.

This policy is at the discretion of individual doctors to be implemented when appropriate for suitable patients.

Most patients collecting repeat prescriptions do not pay prescription charges; therefore there will be no difference to these patients in terms of cost due to 28-day prescribing. If you do have to pay prescription charges, then it may be beneficial for you to buy a Prescription Prepayment Certificate especially if you are taking 3 or more medicines on a regular basis. More information is available on this website www.services.nhsbsa.nhs.uk/buy-prescription-prepayment-certificate