28 Day Prescribing Advice Posted or Updated on 22 Mar 2024

For Rotherham GP Practices

The NHS recognises that for most patients 28-day repeat prescribing interval makes the best possible balance between patient convenience, good medical practice and minimal drug wastage. 

The British Medical Association (BMA) notes that "Prescribing intervals should be in line with the medically appropriate needs of the patient, taking into account the need to safeguard NHS resources, patient convenience, and the dangers of excess drugs in the home". 

Multiple studies in the UK and abroad have shown significant savings and a reduction in waste with 28-day prescribing. 

The benefits of 28-day prescribing include (but not limited to) 

• Reducing the amount of medicine which is currently wasted when your doctor stops or changes your medicine
• Reducing the potential for error when your medication is changed in the middle of supply
• Increased safety as you will not have multiple containers of the same medicine meaning it is likely to reduce the number of mistakes made by, for example, elderly patients, and it will also reduce the risk of potential poisoning of young children
• Reduce waste for medicines with potential of changes e.g. medicines which require regular blood monitoring
• Many medicines are supplied in 28-day packs, allowing you to check that you have taken your medication each day. You will start and finish the container of each medicine on the same day of the week, meaning it will be easier for your doctor to review all of the repeat medicines you are taking and to see when you have not ordered your medicines 
• Financial losses due to medicines waste represent a direct loss to patient care. Since 28-day prescribing reduces medicines waste, this in turn has a positive impact on patient care. 
• The Department of Health and Social Care (DHSC) has issued "strong recommendations" that prescriptions for certain medicines, Schedule 2, 3 and 4 Controlled Drugs (CDs), are limited to the quantity necessary for up to 30 days' treatment. 28-day prescribing would aid alignment of all medicines, including CDs, with this advice. 

For some patients on certain medicines at a stable dose (e.g. contraceptives, creams, HRT, inhaler etc), your doctor may decide it is appropriate to issue prescriptions for prescribing intervals longer than 28 days as these medicines are only available in certain pack sizes. 

During the Covid-19 pandemic crisis and due to on-going stock issues with the NHS supply chain, re-enforcing 28-day prescribing is recommended as per guidance from the Department of Health (DoH) to manage and minimise medication shortages. NICE Guidelines also support 28 day prescribing and recommend that "medicines are prescribed for no more than 30 days" (prescribing larger quantities puts the supply chain at risk). 

NHS Prescription Charges

Most patients collecting repeat prescriptions do not pay prescription charges; therefore, there will be no difference to these patients in terms of cost due to 28-day prescribing. If you do not have to pay NHS prescription charges, then it may be beneficial for you to buy a Prescription Payment Certificate (PPC). The PPC covers all your NHS prescriptions for a set price. PPC will save you money if you need more than 3 items in 3 months, or 11 items in 12 months. More info available via www.services.nhsbsa.nhs.uk/buy-prescription-prepayment-certificate