GPonline reported earlier this month that millions of NHS prescriptions cannot be traced back to individual doctors because of a loophole in the way prescribing numbers operate.
The overwhelming majority (84%) of more than 400 GPs who took part in an online survey say the current system of assigning prescription numbers to identify GPs – known as a doctor index number (DIN) – needs to be changed to improve safety.
Just 5% of GPs said the system should not be changed, while 11% indicated they did not know.
Under the existing model, prescription numbers – known as a doctor’s index number (DIN) – are assigned to GPs working in England and Wales by the Health and Social Care Information Centre (HSCIC). These six-digit codes are used when doctors sign off prescriptions for patients.
But each GP’s DIN is tied to the practice they work at by being assigned through their employing organisation. Locums, who do not work at a permanent practice, therefore cannot be given one, and codes cannot be transported with them to different practices.
In most cases, they must use prescribing codes of the doctor for whom they are providing locum services.
This means that data on prescribing trends is non-existent for some GPs – and inaccurate for many more who must loan their number out to other doctors such as locums and trainees.
Only through painstakingly checking every single prescription against practice records could this data be of any use for purposes such as tracking prescribing habits.
At worst, GP leaders have warned that doctors attempting to conceal serial malicious or inappropriate prescriptions could easily slip under the radar.
One GP respondent said: ‘Any doctor should be personally responsible for the prescription he/she writes.’ Another added: ‘I'm a locum, and am happy to have my name on my prescriptions.’
One said changing the system would enable a host of benefits: ‘A very vital feature for quality assurance and also learning point for that GP as things identified after medicine issued may become easier if traced to the GP who signed it.’
This sentiment was echoed by another: ‘In a practice with a high number of locums, it would help support our learning events or significant events.’
But others warned that any system changes would likely be too expensive to be useful. ‘What’s the use?’ said one. ‘You can always audit trail and find out who saw the patient at that time and which locum doctor it was. This would be a waste of money.’