H&W Primary Care Reporting on Provider Contract Prescribing Breaches For Purpose of Trend Reporting

While the majority of requests from Secondary Care to Primary Care to take over prescribing responsibility are appropriate, occasionally they are not. Any requests from Secondary Care (or other provider) to prescribe a drug or device which is not endorsed for use in Primary Care should be reported on the form below. This allows the CCG to monitor and report back on all such requests. In addition, it will be necessary for individual Prescribers to communicate directly with the requester to explain that they will not be able to take on the prescribing as suggested.

The CCG collates information on such requests so they can be raised directly with the providers to minimise future (inappropriate) requests or to prompt review of prescribing guidance where appropriate.

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* 1. Practice name

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* 2. Practice Code (e.g. MXXXXX)

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* 3. Date of Breach

Date / Time

Date

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* 4. Provider

Other (please specify)

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* 5. Please specify site

Other (please specify)

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* 6. Department (if not provided, please specify Ward name/number stated in Provider letter, TAN etc)

Other (please specify)

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* 7. Consultant (or other healthcare professional advising), including job title

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* 8. Was a Treatment Advice Note (TAN) received

Yes

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* 9. Please indicate which area the Provider Contract is believed to have been breached, by selecting the relevant option(s) below. NB. Medicines include prescribable (FP10) appliances e.g. dressings, devices

Medicine not approved for prescribing in H&W; i.e. non-formulary medicine

Formulary medicine but outside H&W prescribing and/or monitoring guidance/policy

Formulary medicine that is not recommended (locally or nationally) for GP/primary care prescribing; i.e. restricted to secondary care prescribing only

Off-label formulary medicine, without established practice to support GP/primary care prescribing; i.e. restricted to secondary care prescribing only

Unlicensed formulary medicine; i.e. restricted to secondary care prescribing only

Under a 'Shared Care' agreement where no copy of agreement received

Due to insufficient supply of medicines received by a patient at discharge (should be complete course of 14 days whichever is shorter)

Due to insufficient supply of dressings/medicines to meet patient post-operative needs following 'day-case' attendance

Inappropriate Treatment Advice Note (TAN) received

Other

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* 10. Name of Drug or Device being requested (if applicable)

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* 11. Please provide details of the breach: (Please do not include Patient Identifiable Data, this includes NHS numbers)

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* 12. Action taken by GP practice

Formulary alternative recommended

Patient advised to buy

Prescribed by GP Practice

Prescribed by Secondary Care Provider

Other (please specify)

Thank you for taking the time to report this breach.