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Fife to bring in £3.9m electronic prescribing regime after study says 99% of written slips have errors

Victoria Hospital, Kirkcaldy.
Victoria Hospital, Kirkcaldy.

A £3.9 million electronic prescribing system is to be introduced at Fife hospitals after a study suggested 99% of written prescription slips contained errors.

NHS Fife is one of the last health boards in Scotland to introduce the Hospital Electronic Prescribing Medicines Administration (HEPMA) system, which health bosses said was vital to ensuring safe dispensing of drugs.

According to a study conducted across NHS Ayrshire and Arran, the system has the potential to reduce prescribing errors at discharge from hospital from 99% to 23%.

Prescriptions written out for a sample group of 159 patients before HEPMA was introduced in Ayrshire and Arran included mistakes relating to lack of information about allergies, omission of medicines and incorrect doses, frequencies and durations of treatment in 158 cases.

When the process was repeated after HEPMA was brought in, the number of patients, out of another sample group of 159, with wrong prescriptions fell to 37.

The research, carried out in partnership with Aberdeen’s Robert Gordon University and published in June 2017, said HEPMA was “not a panacea for prescribing errors” but significantly reduced both the rate and severity of mistakes.

At a recent NHS Fife board meeting, NHS Fife Director of Pharmacy Scott Garden said the 99% figure was “alarming.”

However, he said the prescribing errors picked up by the study “may not have resulted in any harm whatsoever”.

He described the introduction of the HEPMA system as a “transformational project in terms of quality and safety of care.”

Medical director Dr Chris McKenna said: “This is a really important development for Fife as a whole.

“This is a major patient safety initiative which allows doctors and other prescribers to prescribe medicines electronically. This is a major piece of work and is a Scotland wide initiative.

“This is a huge piece of work, which will require lots and lots of training.”

Implementing the system will come at a cost. NHS Fife is expected to contribute £2.5m to the project, with the Scottish Government providing £1.4m.

There will also be recurring costs of in the region of £500,000 a year.

A report prepared for NHS Fife board suggested cost pressures could be eased by collaboration with other health boards.

“The recurring revenue identifies the additional recurring requirement for system support and pharmacy staff. Cash releasing benefits are anticipated but have not been assumed, given the lack of an evidence base nationally,” said the report.

In addition to reducing errors associated with handwritten prescriptions, it is anticipated the system will result in the time spent on ward drug rounds being halved.

The NHS Fife report said: “HEPMA is also a key missing component of an electronic health record and if not adopted NHS Fife will fall behind other health systems in relation to digital maturity, public health intelligence and medicine related research.

“In addition, HEPMA has been successfully implemented in a number of other health boards in Scotland and non implementation within NHS Fife would result in an inequality of service delivery for service users within the health board area.”

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