Chris Lancelot: Why we need a central prescribing database

The Care Quality Commission (CQC) is concerned about the communication of prescribing information between primary and secondary care. Drug lists can be out of date; many practices don't have a protocol for reviewing the patient's medication after discharge; and updating medication in primary care is sometimes left to administrative staff.

This is all potentially dangerous. Up to 4 per cent of hospital admissions may be due to preventable medication-related problems.

Part of the CQC's solution is for GPs to review patients' medication immediately after discharge, preferably with the patient present; they also think that increased use of the summary care record (SCR) will improve information quality.

The CQC is right about poor communication. However, the SCR is merely a copy of part of the patient's record (which may already be inaccurate). The CQC's suggestion that 'GPs should do more' won't help either: we have enough to do already without adding further administrative work.

So why not change the prescribing system so it is automatically up to date? Currently, prescribing information is stored in many different places, such as the practice computer and in hospital records. These separate databases can easily get out of sync - the underlying problem.

Instead, the NHS should keep all drug data on a single, central database and, crucially, require all prescribing, both NHS and private, to be performed directly from this shared database. By all means retain individual practice, private or secondary care computer systems, but when a prescription is being created or dispensed the computer would actually be working directly on the central medication record.

All prescribing changes, wherever made, would immediately appear on this central record, which would therefore invariably be complete, accurate and up to date.

Good information management like this could increase medical care quality while reducing administration. A single, shared prescription database should have been the first concern of Connecting for Health, rather than the present convoluted and expensive structure. How many lives have been lost because no one thought to put it in place?

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Pension tax solution for judges shows government could do more for doctors, says BMA

Pension tax solution for judges shows government could do more for doctors, says BMA

Government plans to 'effectively exempt judges from pension tax' show the government...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

Second-phase COVID-19 vaccine rollout maintains prioritisation by age

Second-phase COVID-19 vaccine rollout maintains prioritisation by age

The Joint Committee on Vaccination and Immunisation (JCVI) has published advice on...

PCNs paid £70m for first-wave COVID-19 jab campaign as NHS plots next phase of rollout

PCNs paid £70m for first-wave COVID-19 jab campaign as NHS plots next phase of rollout

Primary care network (PCN) COVID-19 vaccination sites have been paid £70m this month...

London GP personally calling at-risk patients to boost COVID-19 vaccine uptake

London GP personally calling at-risk patients to boost COVID-19 vaccine uptake

London GP Dr Farzana Hussain is personally telephoning scores of patients who have...

Half of patients with possible cancer symptoms avoided contacting GP in first wave

Half of patients with possible cancer symptoms avoided contacting GP in first wave

Almost half of people who experienced potential cancer symptoms in the first wave...