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Repeat prescription management: How Pharmacist-Led Systems Reduce GP workload and Improve Patient Safety
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Repeat prescriptions make up almost as much as two thirds of a practice’s total prescribing activity, yet many practices still rely on fragmented, manual processes that create unnecessary workload for clinicians and administrative staff. A clinical pharmacy-led repeat prescription support service provides a safer, more consistent and more efficient approach to medicines management, particularly when supported through structured services such as clinical pharmacist support and pharmacy technician support.
This article outlines how managed repeat prescription systems work, the challenges they solve, and how Clinical Pharmacists and Pharmacy Technicians improve workflow efficiency across GP practices and Primary Care Networks (PCNs). Practices seeking wider support can also explore our integrated services and support.
Key takeaways
- A managed repeat prescription support service reduces GP workload by transferring appropriate tasks to trained Clinical Pharmacists and Pharmacy Technicians.
- Clinical Pharmacists improve patient safety by managing monitoring, high-risk medicines and clinical decision making.
- Pharmacy Technicians ensure accurate synchronisation, record-keeping and workflow efficiency.
- Electronic repeat dispensing (eRD) reduces administrative burden for both practices and patients.
- A structured system improves consistency, governance and quality across repeat prescribing.
What is repeat prescription management?
Repeat prescription management refers to the systems and processes used to issue, review and monitor medicines prescribed on a repeat basis. This includes authorising requests, aligning quantities, maintaining monitoring requirements and managing high-risk medicines in line with clear repeat prescribing policies.
A high-quality system balances three priorities:
- Patient safety
- Workload reduction
- Consistent governance
Given the volume of repeat requests, even small inefficiencies can have a large operational impact. Clinical Pharmacists and Pharmacy Technicians therefore play an essential role in modern primary care medicines management, often working as part of wider medicines optimisation and safety programmes.
What is the procedure for managing repeat prescriptions in GP practices?
While each practice may have its own workflow, most repeat prescribing processes follow a standard NHS-aligned structure. This ensures requests are safe, clinically appropriate and supported by accurate patient data. A typical internal workflow includes:
- Reviewing the request
- Checking monitoring requirements
- Confirming quantities and synchronisation
- Assessing whether a Structured Medication Review (SMR) or clinical decision is required
- Applying local repeat prescribing policies
- Issuing or escalating the request
Clinical Pharmacists and Pharmacy Technicians streamline this pathway by completing the majority of checks and documentation, ensuring only clinically complex cases reach the GP.
What are the core steps in an effective GP repeat prescribing workflow?
A well-governed repeat prescribing workflow typically involves:
- Patient request received
Requests arrive via online systems, the NHS App, eRD schedules, pharmacy queries or reception.
- Initial screening by Pharmacy Technicians
This includes checking quantities, recent activity, missing information, synchronisation issues and basic monitoring.
- Clinical review by a Clinical Pharmacist
High-risk medicines, abnormal results, overdue monitoring or unclear requests are escalated for clinical decision making.
- Issuing the repeat
If appropriate, the prescription is authorised under local protocols.
- Updating clinical records
Documentation is completed to maintain accurate, auditable and CQC-compliant records.
- Communication with the pharmacy or patient
Clear instructions minimise duplicate requests or follow-up queries.
Why should practices use a fully managed repeat prescription service?
A managed, pharmacy-led model creates a consistent approach that supports both clinical and operational performance.
1. How does a managed service reduce GP workload?
Clinical Pharmacists and Pharmacy Technicians can safely:
- Authorise appropriate repeat requests
- Complete routine checks
- Handle medication queries
- Manage synchronisation
- Identify when a clinical review is required
- Make clinical decisions within their scope of competence
This reduces the volume of tasks passed to GPs, freeing clinical sessions for direct patient care. In larger practices or PCNs, partnering with a remote prescribing service can accelerate these benefits.
For example, in a practice with 10,000 patients, reducing GP involvement in just 20 percent of repeat requests can create several hours of clinical capacity each week.
2. How does a managed service improve safety and governance?
Medication errors often arise from issues within repeat prescribing systems. A structured model ensures:
- Monitoring is up to date
- Quantities are appropriate
- Interactions are checked
- High-risk medicines follow strict protocols
- Policies are applied consistently across teams
This supports Care Quality Commission (CQC) expectations and strengthens governance. PCNs looking to standardise medicines processes across multiple practices can also access primary care network management support.
3. How do Clinical Pharmacists support medicines optimisation?
Clinical Pharmacists identify opportunities to:
- Reduce overprescribing
- Remove outdated or unnecessary repeats
- Simplify medicines regimens
- Introduce better value alternatives
- Assist with medicines management
Many PCNs align this work with Structured Medication Reviews and long-term condition clinics to maximise impact.
4. What are the benefits of electronic repeat dispensing (eRD)?
Electronic repeat dispensing can issue up to 12 months of medication for suitable patients. When implemented effectively, it can reduce administrative workload by up to two thirds.
A clinical pharmacy-led team helps to:
- Identify eligible patients
- Prepare and update patient records
- Align quantities
- Manage exceptions
- Support patient communication
Adopting eRD at scale works particularly well alongside wider long-term condition management.
5. How does a managed service create consistency across practices or PCNs?
A centralised clinical pharmacy-led prescribing hub model provides through a specialist provider like Core Prescribing Solutions :
- Standardised workflows
- Shared protocols
- Stronger audit trails
- Enhanced reporting
- Greater team resilience
This is especially valuable for networks using Additional Roles Reimbursement Scheme (ARRS) staff and can be supported through our dedicated ARRS support.
What rules and policies shape safe repeat prescribing in the NHS?
Practices must follow a combination of national NHS guidance, local Integrated Care Board (ICB) policies and internal governance procedures. These typically include:
- Monitoring intervals and blood test requirements
- High-risk medicine protocols
- Clear definitions of repeat vs acute medication
- eRD suitability rules
- Medicines optimisation frameworks
- CQC expectations around documentation and safety
A managed service ensures these policies are applied consistently across teams and sites, reducing variation and clinical risk.
Common challenges and barriers to implementing a repeat prescribing system
Practices often encounter similar barriers when improving repeat prescription processes:
- Unaligned quantities leading to repeated out-of-sync requests
- Inconsistent coding and missing monitoring data
- Variation in GP confidence when delegating authorisation to pharmacy teams
- Lack of a unified protocol across multi-site PCNs
- Patients unsure about changes such as eRD or synchronisation
- Multiple inboxes and access points leading to duplication of work
A managed service resolves these through standardised workflows, clear governance and trained pharmacy-led oversight.
Cost-benefit: What is the ROI of managed repeat prescription services?
A clinical pharmacy-led prescribing hub delivers measurable value. Examples include:
- Reducing GP sign-off workload by 20 to 40 percent
- Increasing eRD use, typically reducing admin workload by 50 to 67 percent
- Cutting medicines waste through deprescribing programmes
- Reducing the number of patient queries related to repeat requests
- Streamlining workflow to shorten turnaround times
Many PCNs also reinvest freed time into long-term condition clinics, improving Quality and Outcomes Framework (QOF) performance.
Mini case example: A PCN improving workflow efficiency
A PCN of 46,000 patients implemented a Clinical Pharmacist-led repeat prescribing system across four practices. Within 12 weeks:
- GP sign-off workload decreased by 32 percent
- eRD uptake increased from 8 percent to 41 percent
- High-risk medicines monitoring compliance improved significantly
- Duplicate requests reduced through better synchronisation
- Patient feedback highlighted clearer communication and faster turnaround times
This demonstrates the long-term value of consistent, pharmacy-led medicines governance.
How Clinical Pharmacists and Pharmacy Technicians work together
Pharmacy Technicians
Responsible for:
- First-line screening
- Synchronising quantities
- Managing administrative elements
- Identifying missing information
- Ensuring accurate records
- Supporting eRD setup
Clinical Pharmacists
Responsible for:
- Clinical decision making
- High-risk medicines
- Complex or ambiguous requests
- Structured Medication Reviews (SMRs)
- Long-term condition support
- Governance and oversight
These functions are supported through flexible Clinical Pharmacist support services.
Quote from Adeem Azhar, Chief Executive Officer of Core Prescribing Solutions
Our goal is to provide practices nationwide with a safer, smarter and more consistent way to manage repeat prescriptions. When Clinical Pharmacists and Pharmacy Technicians lead the process through a specialist clinical service provider, GP teams can focus on clinical care with more complex needs, patients benefit from a more reliable system, and the practice gains a repeat prescribing model that is both efficient and clinically robust.
Frequently asked questions
Summary
Repeat prescription management is a major contributor to GP workload, with direct implications for safety, efficiency and patient experience. An end to end managed clinical pharmacist-led repeat prescribing service strengthens governance, reduces GP burden, supports eRD adoption and improves medicines optimisation across primary care. With clear protocols, skilled clinical pharmacy teams and repeat prescription governance, practices gain a more reliable and long-term value approach to managing repeat prescriptions.
