Repeat Prescriptions

Policy

We apply a safe and consistent approach to repeat prescribing, guided by the Principles for Quality and Safe Prescribing Practice.

The Principles for Quality and Safe Prescribing Practice have been developed collectively by the seven authorities who regulate prescribers, including the Medical Council of New Zealand, Nursing Council of New Zealand, and Pharmacy Council of New Zealand.

All repeat prescriptions must be authorised by a prescriber, either the original prescriber or another prescriber at the practice. Each prescriber must meet the standards for repeat prescribing from their relevant professional body. Legal responsibility for all prescribed medications remains with the prescriber.

Repeat prescriptions are either sent to the pharmacy via NZePS or collected from reception. All relevant information about the repeat prescribing process is recorded in the patient notes in the PMS.

Repeat prescriptions are appropriate only for enrolled/registered patients, who report their condition as stable and have been reviewed within the last 12 months.

These guidelines may be varied at the prescriber's discretion for individual patients. Any variation from the guidelines is documented in the PMS.

We follow consistent guidelines for specific medications and conditions to ensure:

• appropriateness is assessed at least annually
• prescribing is safe and reliable, resulting in good control
• unwarranted variation is reduced.

For all best practice recommendations, refer to NZ Formulary and MIMS medicines information.

If the repeat prescription request is not approved, note the reason in the PMS and advise the patient they need to make an appointment for a consultation. If appropriate the patient may be given a short-term supply to ensure they have continuity of medication.

We can add any specific measures you have in place to reduce medicine inequity.

Prescribers should consider inequities around access to repeat prescriptions and collection of medication. Groups disproportionately affected by inequities, such as Māori, may need additional support to increase adherence.

If potential inequities are identified for a patient, consider what service, support, or resource is available, e.g. increase medicine adherence by adding a reminder for the nurse to follow up in six weeks. This is documented in the patient record.

Repeat prescribing procedure

Do you need any changes to the repeat prescribing procedure?

Patients may request repeat prescriptions via the ManageMyHealth patient portal, email, phone, or in person.

Repeat prescription requests are managed by the nursing team. Key details are always checked.

1. The patient requests a repeat prescription and provides their full name, contact details, medication(s) and preferred pharmacy.
2. Forward the request to the patient's prescriber (or their deputy) to check whether the prescription can be approved and details are correct.
3. Generate the prescription and send to the pharmacy.
4. Administration staff invoice the patient for the prescription fee, and document when the prescription has been sent.
5. Notify patient when prescription is ready. 

This sentence is optional. You can also add other steps you take to reduce inequities around repeat prescribing.

If patient is at risk of inequities from non-collection or non-adherence to medications, the nurse sets a reminder to follow up in six weeks.

See also Prescriptions, and Controlled Drug Prescriptions

Urgent requests

If a medication is required urgently, it may be appropriate to issue a repeat prescription for a patient who is unable to visit the practice. This is the prescriber’s decision and may depend on the nature of the medication.

If there is doubt about whether a repeat is appropriate without a review, the prescriber may decline it until the patient is able to come in. If interim medication is necessary before the appointment, a short-term prescription may be issued.

Audits

Repeat prescribing is audited annually by checking a random selection of patients who are currently taking long-term medication. If the audit reveals any instances where the policy and procedures are not being adhered to, improvement actions should carried out, followed by another audit.

To identify inequities, audits differentiate Māori from non-Māori.

The RNZCGP Repeat Prescribing Audit Form template can be used to record audit findings.

Clinical governance

Areas for potential improvement identified in the audit are discussed at clinical meetings and used to improve our performance, e.g. inconsistencies, errors, or abnormal prescribing patterns. Individual prescribers take part in quality activities such as peer review and continuing education, in line with their relevant professional requirements.

Any major issues identified with repeat prescribing are considered as part of clinical governance so we can identify whether changes to processes are needed, or a quality initiative should be carried out.

Script

Repeat prescription documents

Please check and amend this list of different medications to suit your practice

Repeat prescription guidelines for specific medications and conditions