Responsibility, accountability and factors influencing provision of pharmacist transcription of discharge prescriptions

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Abstract
Objectives To investigate the legal issues concerning authorisation of pharmacist transcribed discharge prescriptions and the prevalence of formal protocols for such a service, and to identify the factors influencing the decision on whether to provide a pharmacist discharge prescription transcription service (PDPTS). Method Postal questionnaire survey of clinical pharmacy managers. The sample included one hospital in each of the acute trusts in the UK. Key findings The questionnaire completion rate was 66% (135/206). Thirty-six per cent of pharmacy departments (49/135) reported that they offered a PDPTS. The majority of the pharmacy departments with a PDPTS required a medical practitioner to countersign the pharmacist-written prescription (65%) and had a formal protocol for their PDPTS (57%). Seven hospitals reported that they ‘sometimes’ asked the doctor to countersign/authorise the discharge prescription, and 10 hospitals reported that they did not ask the doctor to countersign/authorise the prescription. The most common reasons for implementing a PDPTS were to reduce delays in the discharge process (73%) and to reduce errors (50%). Among pharmacy departments with no plan to provide a PDPTS, the main reasons given for not developing this service were insufficient resources (62%) and preferentially developing other services (24%). Conclusion There is currently no consensus upon authorisation requirements of pharmacist-written discharge prescriptions and the legal position is unclear. The hospital pharmacy departments that ‘sometimes’ request a medical practitioner's counter-signature raise clinical governance and medico-legal issues, especially if their practice deviates from trust policy. The reasons given for implementation of a PDPTS concur with those found in previous studies.

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