NHS Community Pharmacy Website

Medicines: Care & Review (M:C&R)

Refresher Session 19/05/2021

Good Practice Guidance for Prescribing Quantities v2.2 - June 2020

Serial Prescribing Communication from CP GGC & NHSGGC

Serial Prescribing Quick Reference Guide v2.3 - April 2021

Serial Prescribing FAQs v3.0 - March 2021

Serial Prescribing Information Sheet for Patients v1.0

Serial Prescribing Patient Nomination Form v1.0

Directions and Service Specification 2021

Medicines: Care and Review (M:C&R) is an updated and refreshed service for community pharmacy contractors and replaces the previous Chronic Medication Service (CMS). The formal launch of the service and its new name, has been delayed due to changes to Minor Ailment Service and the subsequent launch of new NHS Pharmacy First. More information on the launch and service implications will be shared here once these have been finalised and agreed between Scottish Government and Community Pharmacy Scotland.

In the meantime, it is business as usual with most of the guiding principles being as before. As part of the service change preparations, there have been some changes that affected the management of serial prescribing. Some PMR systems and GP IT clinical systems will still refer to CMS and this will change over the next 18 months.

Key changes for serial prescribing are:

Decoupling of registrations within GP IT clinical systems. This allows the prescriber to generate a serial prescription (SRx) for any patients who meets the criteria but without the patient being registered at a community pharmacy.
Prescribing support teams are more proactively involved in identifying possible patients and converting them on to a SRx.
Community pharmacy teams can still suggest or nominate a patient for a SRx if appropriate using the nomination form.
Most SRx will be prescribed for 56 weeks and at 8 weekly intervals.
‘When required’ or PRN meds are allowed to be prescribed and quantities adjusted to allow for expected annual use. This reduces risk of over ordering and waste.
Community pharmacy teams should check with the patient before dispensing any PRNs on a SRx.
Electronic claims must be sent in a timely manner after the medication is supplied to the patient and not at the point of assembly/dispensing. This claim updates the GP IT clinical record and Emergency Care Summary (ECS). It is also the message that triggers drug reimbursement.

A Shared Care Agreement is available to help community pharmacies and GP practices discuss and agree implementation of serial prescribing.

Serial prescribing does not rely on patient registration though this is still used as an enabler to support the electronic message flow between the community pharmacy, GP practice and ePharmacy Message Store (ePMS).

Serial prescription management is a Level 1 task within pharmacotherapy in the GP contract. Prescribing support pharmacy teams will have an increased focus on this as part of the pandemic planning. By increasing the numbers of patients receiving a serial prescription, this provides the community pharmacy teams with greater control over who and when accesses the pharmacy to collect medication and support stock control. It will also reduce the risk of transmission as there is less paper in the system.

The ePharmacy facilitators are available to help, support and train. They will train pharmacy teams as part of a planned programme and in collaboration with you. Pharmacy Champions will also be able to support with serial prescription management in the community pharmacy.

Training videos can be found below:

NHSGGC - TSR reports

NHSGGC - SRx process including PRN's

NHSGGC - Synchronising a SRx

NHSGGC - SRx for Pharmacies

NES Vimeo - Serial Prescribing

NES Vimeo - Serial Prescribing Management

NES Vimeo - Serial Prescribing Message Awareness & Housekeeping

Other Resources:

NHS Services Scotland (PSD) Website

NHS Education for Scotland (Pharmacy) Website

GP videos can be found below:

A Guide for GP Practices (Vision)

Changes for GP Practices (Vision)

A Guide for GP Practices (EMIS)

Changes for GP Practices (EMIS)

Care Plans

As part of the ongoing support for Medicines: Care and Review and in particular, the care aspect of the service, we have reviewed and updated the generic care plans that were originally distributed in 2012. These care plans cover the most common therapeutic areas and are written in such a way to replicate the new care issue entries within the Pharmacy Care Record.

Please use these generic care plans whilst discussing medication and care issues with patients, particularly as use of serial prescribing is increasing.