Serial Prescribing in Care Homes

Residents who live in care home settings are now eligible to register with a community pharmacy and participate within the new Medicines: Care and Review (MCR) service. MCR has three key elements – medication review, provision of pharmaceutical care and serial prescribing. The service is well embedded into daily practice for people who do not live in a care home setting, however, it is a new concept for care homes and required feasibility testing to help support potential change in medication management processes.

Five health boards have been participating in a pilot to test the application of serial prescriptions (SRx) in a care home.  The pilot has successfully demonstrated that SRx can be used within care home settings and has provided improvements in communication between the care home, the GP practice team and community pharmacy. In addition, it has also resulted in reduced interim prescription requests and a reduction in unnecessary pharmaceutical waste/drug returns.

A SRx is a prescription that may be supplied to people who have a long-term condition(s) and will remain valid for up to 56 weeks, with items dispensed in accordance with a dispensing frequency defined by the prescriber. The main differences between a repeat prescription and a SRx are that the person does not need to reorder a prescription each time an item is required. This brings a fundamental change to how prescriptions are managed within the care home for residents with stable medication regimes for long term conditions.

SRx is supported by electronic messaging (ePharmacy system) between general practice and the community pharmacy. GPs will receive notification on the next working day after an item is dispensed; this notification will update the GP patient record as well as the patient’s Emergency Care Summary (ECS).

As SRx is underpinned by the ePharmacy system, it is important that if a care home is considering using an electronic MAR system in its service, the new eMAR should be compliant with the Scottish ePharmacy processes.   Each health board has an ePharmacy facilitator who can offer advice if needed.

The national project team is now working to expand the pilot to other health boards in a controlled and supported manner as we continue to test in new scenarios whilst aiming to achieve the same positive results and gather real time intelligence that will be shared to support the wider network as this programme rolls out.    We look forward to your support in this process to improve the medicine system for the benefit of residents and staff.

Last Updated on 4th August 2022 by Shanice