Doctors in Scotland are urging the government to introduce a national prescribing chart, claiming that the current lack of standardisation is “one of the most significant contributory factors” to prescribing errors.

A recent study by the General Medical Council found that, in a one-week period, 5.9% of consultants and 10.3% of trainee doctors in UK hospitals had made prescribing errors, some of which could have been potentially fatal for patients, says the Royal College of Physicians in Edinburgh.

While there can be many reasons why prescribing errors occur, a recent comparison by the College of the various prescribing charts developed by individual Health Boards throughout Scotland found that these can vary significantly, which contributes to prescribing errors and compromises patient safety, it says. The risk increases as doctors, and particularly those in training, move from hospital to hospital and use inconsistent prescription recording systems.

“The accuracy of these charts is vital to ensure correct medication selection and dosing, to avoid potential adverse interactions with other prescribed medicines and to inform clinical decision-making about treatment options,” the RCPE adds.

The doctors’ group is calling on the Scottish government to follow the lead of Wales, which in 2004 introduced a national prescribing chart with associated prescribing standards.

Patients expect standardised Rx-ing

“Local variation in prescribing charts has existed for many years, but has not been addressed by successive governments and should now be given greater priority,” said RCPE president Neil Dewhurst. “Putting it simply, patients should expect a standardised system of prescribing regardless of which hospital in Scotland they are treated.”

“Doctors also frequently move around the NHS within the four home countries of the UK. It would, therefore, be logical to follow Wales’ example by developing a national prescribing chart for Scotland initially and then to work towards a UK-wide prescribing chart for use across the whole of the NHS,” Dr Dewhurst added.

The College adds that adoption of a standardised prescribing chart would also offer an ideal opportunity to support other quality improvement measures, including the implementation of nationally-agreed clinical guidelines; for example, the inclusion within standardised prescribing charts of regular screening for venous thromboembolism risk would ensure patients were regularly monitored throughout their stay in hospital. With 25,000 deaths a year across the UK attributed to VTE, a prominent reminder on a standardised drug chart would ensure patients are screened regularly and receive appropriate and timely interventions, say the doctors.