Market Rasen Surgery
28 Day Prescribing
Market Rasen Surgery operates a 28 day repeat prescribing policy. The surgery recognises that this provides the best balance between patient convenience, good medical practice and minimal drug wastage.
A standard 28-day repeat prescribing interval supports the practice in providing a robust and efficient repeat prescribing system.
The policy standardises the repeat prescribing process and aids efficiency, it also supports individuals to take responsibility for ordering their own medication. It simplifies the monitoring of efficacy, safety, and compliance with medicines. The 28-day prescribing interval allows patients to have the medicines they require, without the need to stockpile and potentially waste medicines.
How will 28-day prescribing affect you?
If you are prescribed a “repeat medicine” the clinician will commence enough to last 28 days. For example, if you are taking 2 tablets a day you will receive 56 tablets, 3 tablets a day 84 tablets, 4 tablets a day 112 etc.
Exceptions
However, there are exceptions when a shorter interval (7–14 days) may be appropriate, initially to assess effectiveness or tolerability of a medicine. Issues such as compliance, safety or drug diversion might also be addressed by a shorter than 28-day repeat prescribing interval.
Some medicines are presented or packaged in a manner that makes them unsuitable for prescribing to a 28-day interval; these include some inhalers, insulin, treatment packs of oral contraceptives and hormone replacement therapy. These will be prescribed in an appropriate quantity.
What are the benefits of 28-day prescribing?
You will always start and finish on the same day of the week which makes it easier for the clinician to review all the repeat medicines you are taking and to highlight any issues you may be having with your medication.
Companies already manufacture many medicines in a 28 day ‘calendar pack’ that shows the day of the week on the packaging. This packaging allows you to check and monitor that you have taken your medication each day. These packs also have patient information leaflets inside and ideally the seal on the pack should not be broken as they are designed to be supplied with the information included.
28-day prescribing reduces the amount of medicine which is currently wasted when medicines are stopped or changed by a clinician. It also reduces the amount wasted when partly filled containers are thrown away.
Many patients make several visits a month to the surgery and local pharmacy as their medication runs out at different times. If the medication can be synchronised this will reduce these visits. It will also reduce the need to make emergency requests.
Will it cost more?
The vast majority of patients collecting repeat prescriptions do not pay prescription charges, therefore there will be no difference to these patients in terms of cost. If you do have to pay prescription charges and you need more than 3 prescription items in 3 months (or more than 11 prescription items in 12 months), the best way to pay for your prescriptions would be to obtain a Prescription Prepayment Certificate (PPC). Please ask at the surgery dispensary or your local pharmacy for more information.
On occasion you may see a note on your repeat prescription slip informing you that you are due a medication review.
This is an opportunity for a GP / Clinical Pharmacists (or in some cases our practice nurse) to check that your medication is still the best treatment for your condition and that the appropriate monitoring and health checks have been carried out. If you have been taking the same medication for many years and your condition is stable it may be possible to conduct your medication review as a telephone consultation. Please ensure that you book the appropriate appointment when requested to do so to avoid unnecessary delays to future prescriptions.
If you receive treatment from a specialist, the GP will still require you to attend for a medication review if your prescriptions are supplied by the surgery. The reason for this is that the prescribing GP holds clinical responsibility for the medication issued.
While repeating medication without seeing the doctor is convenient for patients, we still have to ensure you are using your medications safely. Each request is reviewed individually.Please do not assume that your request will be granted automatically. We are sorry if this causes any inconvenience.
Prescription Charges and Exemptions from 1st April 2023
Extensive exemption and remission arrangements protect those likely to have difficulty in paying charges (NHS prescription and dental charges, optical and hospital travel costs).
The NHS prescription charge is a flat-rate amount which successive Governments have thought it reasonable to charge for those who can afford to pay for their medicines. Prescription prepayment certificates (PPCs) offer savings for people who need extensive medication. These can be obtained from selected pharmacies or online at www.
NHS charges
These charges apply in England only. In Northern Ireland, Scotland and Wales prescriptions are free of charge.
The current NHS prescription charge is £9.65 per item
Are you missing out on prescription charge savings?
A prescription prepayment certificate could save you money if you pay for your NHS prescriptions. The certificate covers all your NHS prescriptions, regardless of the number of items, for a set price. You will save money if you need more than 3 items in 3 months or more than 11 items in 12 months.
- A 3 monthly PPC is £31.25 and will save you money if you need more than three prescribed items in three months.
- A 12-month certificate is £111.60 and will save you money if you need more than 12 prescribed items in a year.
Hormone Replacement Therapy (HRT)
You can now purchase an HRT prescription prepayment certificate (HRT PPC) from the NHS if you’ve been prescribed an eligible hormone replacement therapy (HRT) medicine. The HRT PPC costs £19.30 for 12 months.
It will cover all your eligible HRT prescriptions for that period, no matter how many different medicines you need. There is no limit on the number of HRT prescription items you receive while the certificate is valid. These can be purchased online at www.
Please ask the dispensary staff for information.
Patient information
Requests for converting specialist private prescriptions to NHS prescriptions (FP10)
In the interest of patient safety, please note that a private prescription cannot simply be converted to an NHS prescription. GPs take full legal and clinical responsibility for all prescriptions they sign. The GP must therefore make an assessment ensuring sufficient information has been given to accept this responsibility as the patient has been clinically diagnosed by another specialist healthcare professional. Before a NHS prescription can be issued, the GP must have received a letter from the private consultant explaining the precise details of the prescription; what it is being used to treat; how long the treatment is intended for; and what monitoring or follow up is required.
Please allow 5 full working days for this process. (Excluding bank holidays)
A private prescription request will be considered by a GP – It will not be issued automatically, and patients may be requested to make a face to face or telephone appointment with a GP or Clinical Pharmacist. In this case, patients will be contacted.
If the GP is unable to issue a NHS prescription, patients can still obtain the medication by paying for it privately with the prescription issued by the specialist at any community pharmacy.
The GP/Clinical Pharmacist may refuse to issue you with an NHS prescription for the following reasons:
- If the GP considers that there is a not a clear clinical indication for the prescription, and that in the same circumstances an NHS patient would not be being offered this treatment.
- You have requested a medication that has never been prescribed by a clinician at this surgery
- If the private specialist recommends a new or experimental treatment or recommends prescribing a medication outside of its licensed indication.
- You have requested your repeat prescription too early (the GP/Clinical Pharmacist might be concerned that you are taking your tablets too often and that they are running out too early).
- You have requested an item which is not usually given as a repeat prescription (controlled drugs, antibiotics, or steroid creams)
- You have not been seen by a clinician for a while and you need to have routine monitoring and health checks before your medication can be safely issued.
- You have given us a handwritten prescription from a hospital which you were supposed to take to a hospital pharmacy. (see below)
- If the medication recommended is not generally provided within the NHS.
- If the medication is of a specialised nature requiring on-going monitoring, some GPs may feel that they have insufficient information to accept responsibility for the prescription.
Hospital Outpatient Letters
Hospital Outpatient requests are non-urgent, and this should be clearly stated on the reverse of the hospital form. As above, a prescription will not be issued automatically, and patients may be requested to make a face to face or telephone appointment with a GP or Clinical Pharmacist. In this case, you will be contacted. Please allow 7 full working days for this process as the GP may be required to discuss the request with the hospital specialist team.
Hospital Prescriptions
You should not bring us prescriptions issued by hospital outpatient clinics. It is often not possible for us to issue these prescriptions without the accompanying clinic letter which the hospital may not send to us until a few weeks after your appointment. Please take these prescriptions to the hospital pharmacy, as you should have been advised at your appointment.
Emergency requests for medication
Requests for medication to be issued on the same day (emergency prescriptions) put a strain on our GPs and Dispensers, therefore we would encourage patients to order their medication before their supply runs out. There are a number of convenient ways to order your medication. Please visit our website www.
We understand that occasionally it is necessary to request medication urgently and at short notice. We would be grateful if you could inform the dispensary, explaining the reason your medication is required urgently to ensure it can be assessed by a GP or Clinical Pharmacist and then dealt with by a dispenser.
Any EMERGENCY PRESCRIPTIONS should be available for collection after 16:00 the same day. Please only use this service in an emergency but be aware that it is not always possible to issue an emergency supply of medication at short notice.
The GP may decide that the medication requested is not of an urgent nature, in which case your prescription will be ready for collection in the usual two full working days.
The Duty GP may only issue a 7-day supply of the requested medication as an emergency.
One You Lincolnshire (Be Smoke Free)
Patients can now self-refer to this service, please contact 01522 705162 or online at www.
Prescription requests for patients attending the One You Lincolnshire be-smoke free programme will be available for collection 3 full working days from receipt of advisory document.
Shared Care Protocol
We prescribe certain medications on what is known as a "shared-care protocol" (examples include Methotrexate, Melatonin and Azathioprine).
This means that the patient remains under the care of the hospital specialist, but the prescription is issued by the GP. The initiating hospital specialist is responsible for ensuring that patients receive relevant counselling, including warnings, potential side effects and interactions prior to initiating treatment.
All baseline checks will be done by the specialist prior to requesting shared care from the GP.
Continued monitoring e.g., blood tests and ECGs remain the responsibility of the initiating hospital specialist, but blood tests can be carried out at the surgery providing we have the correct blood forms that the specialist will provide.
A management plan for the duration of treatment will be created by the hospital specialist at the point of initiation.
Once stabilisation has been achieved the hospital specialist will then ask the GP to take on the prescribing of the medication. Once this has been agreed all future prescriptions will be issued from the surgery.
Some drugs issued under shared care require regular monitoring of blood tests to ensure their safety. If the patient is having their blood test monitoring done at the hospital, the GPs at Market Rasen Surgery reserve the right not to issue the prescription until they have up to date copies of the blood test results. It is the patient’s responsibility to ensure that we are receiving copies of their blood results.
Prescribing medication
The GPs at Market Rasen Surgery believe that providing the best possible care to our patients is our top priority. When a prescription is necessary our main considerations are effectiveness and safety. We would never let cost come before patient care but at the same time we try to provide the best value to the NHS by prescribing from an approved list of medicines which meet these considerations.
This list is known as a formulary, and we are sometimes asked by a hospital doctor to prescribe medications which are either restricted to the local hospital formulary or are not on either the local hospital or GP formulary. It is not always possible to prescribe these medications but when these situations arise, we will seek advice from the Lincolnshire Medicines Management Team in order to find a solution for our patients.
Medication supplies when travelling abroad
Market Rasen Surgery follows the NHS rules on the provision of medication when travelling abroad. The NHS allows a maximum of 3 months’ supply of medication to cover whilst travelling out of the country. Unfortunately, we cannot exceed this, and patients will need to make arrangements whilst abroad for repeat prescriptions if out of the country for longer than 3 months. There are situations where it may not be safe or lawful to provide 3 months of a particular medication if its effects need to be monitored closely. For further information please visit the NHS choices website
Please contact the consulate of the country you are visiting for guidance on carrying controlled drugs as each country has their own rules and regulations.
Hospital Outpatient requests are non-urgent and this should be clearly stated on the reverse of the hospital form.
As above, a prescription will not be issued automatically and patients may be requested to make a face to face or telephone appointment with a GP. In this case, you will be contacted.
Please allow 7 full working days for this process as the GP may be required to discuss the request with the hospital specialist team.
You should not bring us prescriptions issued by hospital outpatient clinics. It is often not possible for us to issue these prescriptions without the accompanying clinic letter which the hospital may not send to us until a few weeks after your appointment.
Please take these prescriptions to the hospital pharmacy, as you should have been advised at your appointment.
Requests for medication to be issued on the same day (emergency prescriptions) put a strain on our GPs and Dispensers, therefore we would encourage patients to order their medication before their supply runs out. There are a number of convenient ways to order your medication. Please speak to our dispensary team for advice.
We understand that occasionally it is necessary to request medication urgently and at short notice. We would be grateful if you could inform the dispensary, explaining the reason your medication is required urgently to ensure it can be assessed by a GP and then dealt with by a dispenser.
Any EMERGENCY PRESCRIPTIONS should be available for collection after 16:00 the same day. Please only use this service in an emergency but be aware that it is not always possible to issue an emergency supply of medication at short notice.
The GP may decide that the medication requested is not of an urgent nature, in which case your prescription will be ready for collection in the usual two full working days.
The Duty GP may only issue a 7 day supply of the requested medication as an emergency.
We prescribe certain medications on what is known as a “shared-care protocol” (examples include Methotrexate, Melatonin and Azathioprine).This means that the patient remains under the care of the hospital specialist but the prescription is issued by the GP.
The initiating hospital specialist is responsible for ensuring that patients receive relevant counselling, including warnings, potential side effects and interactions prior to initiating treatment.All baseline checks will be done by the specialist prior to requesting shared care from the GP.
Continued monitoring e.g. blood tests and ECGs remain the responsibility of the initiating hospital specialist. A management plan for the duration of treatment will be created by the hospital specialist at the point of initiation.
Once stabilisation has been achieved the hospital specialist will then ask the GP to take on the prescribing of the medication. Once this has been agreed all future prescriptions will be issued from the surgery. Some drugs issued under shared-care require regular monitoring of blood tests to ensure their safety.
If the patient is having their blood test monitoring done at the hospital, the GPs at Market Rasen Surgery reserve the right not to issue the prescription until they have up to date copies of the blood test results. It is the patient’s responsibility to ensure that we are receiving copies of their blood results.
The GPs at Market Rasen Surgery believe that providing the best possible care to our patients is our top priority.
When a prescription is necessary our main considerations are effectiveness and safety. We would never let cost come before patient care but at the same time we try to provide the best value to the NHS by prescribing from an approved list of medications which meet these considerations.
This list is known as a formulary and we are sometimes asked by a hospital doctor to prescribe medications which are either restricted to the local hospital formulary or are not on either the local hospital or GP formulary.
It is not always possible to prescribe these medications but when these situations arise, we will seek advice from the Lincolnshire Medicines Management Team in order to find a solution for our patients.
Market Rasen Surgery follows the NHS rules on the provision of medications when travelling abroad.
The NHS allows a maximum of 3 months of medication to cover whilst travelling out of the country. Unfortunately we cannot exceed this and patients will need to make arrangements whilst abroad for repeat prescriptions if out of the country for longer than 3 months.
There are situations where it may not be safe to provide as long as 3 months of a particular medication if its effects need to be monitored closely. For further information see the website NHS choices.