Prescription Security - How Secure is your Practice?
Lost or Stolen Prescriptions
And colleagues at CSU will liaise with you regarding the issue of an alert. You should also send a copy of your completed report form to NHS Protect at email@example.com.
The CSU will issue an Alert on behalf of NHS England – South (Wessex) to appropriate contacts in the relevant area(s).
Information on prescription security has been published by NHS Protect and the guidance document (updated in August 2015) can be found at:
There are two useful aid memoires that summarise the responsibilities for prescribers and practice managers.
The CQC has also published a myth buster covering security of blank computer prescription forms: http://www.cqc.org.uk/content/gp-mythbuster-23-security-blank-computer-prescription-forms
Q: Prescriptions in printers – a number of practices have been told that they must remove the prescriptions at night even though the individual doors are locked and the contract cleaners have all been DBS checked and assurance/evidence given by their employer. The scripts are all numbered and signed out to each of the GPs surgeries, to remove them every night could cause some mix-ups and seems a bit unnecessary especially when in a few cases there is nowhere more secure to put them. One practice said their safe isn’t big enough so it would be just another locked room.
Response from Joanne Ward, Inspection Manager for the Wessex Team South Region at CQC
A. The room where the printer is held often the consulting room, needs to be lockable and that lock applied when the room is vacated even for short periods. Tracking the use of the prescriptions is also needed to ensure prescription fraud is not taking place. Where there is concern about access to the room this is normally managed by risk assessment and if any doubt after a risk assessment some practices do empty printers to a lockable cupboard. This must be clear in their policy. Cleaners can and do have access and this should be risk assessed and checked before having access to that room.
Email to all GPs and Practice Managers in Wessex
This briefing has been put together by the LMC with input from the NHS Counter Fraud Team in order to provide practices with some advice and guidance on how best they can protect themselves from prescription fraud.
Please click here for Prescription Security Model Forms
FACTS AND FIGURES
In 2007/08, it was estimated that NHS lost around £15m to prescription theft and forgery;
- Each practice is responsible for ordering new stocks of prescription pads and boxes of FP10 for use with the electronic clinical records;
- The security of prescription forms is the responsibility of GPs and practices;
- With increased security in community pharmacies, GPs surgeries are being targeted as an alternative source of drugs and prescription forms.
COULD YOU BE NEXT?
It’s a busy Monday morning, if a person posing as a patient walked into one of your consulting rooms would they be able to find a prescription pad and remove it?
Do all your GPs secure prescription pads when they are not in their room?
A patient has stolen a prescription pad from Dr Smith’s consulting room. Would Dr Smith know this has happened? If so, would he be able to quote the prescription identification number? Does the practice have a system of recording these numbers?
HOW CAN YOU PROTECT YOUR PRACTICE?
The following recommendations are intended to provide advice on addressing areas where your practice may be most vulnerable to prescription fraud.
Prescription Stationary Stock Control:
- Record prescription pads and boxes received with serial numbers;
- Store items in a secure place;
- When a prescription form is issued to an authorised prescriber, make a record of the serial number and who it is issued to.
- Stolen Prescription Pads:
- Inform the police;
- Notify the Local Area Team of the NHS England
- Inform local pharmacies;
- Agree for a period of 2 months to use a specific colour to sign prescriptions.
- The prescription pad should be inside an unidentifiable lockable case;
- The case should not be left on view in the car but stored in a locked compartment such as the boot, and the vehicle should be fitted with an alarm;
- Blank prescriptions should not be left in care homes.
- Prescribers should keep a record of the serial numbers of prescription forms issued to them - the first and last serial numbers of the pad should be recorded;
- Blank prescriptions should never be pre signed;
- Prescribers should ensure compliance with the legal requirements for prescribing controlled drugs.
- If you have locums working in your surgery, ensure they have the appropriate authority to issue electronic prescriptions and that their name appears on the bottom of the prescription. Most GP computer systems allow this and will add a responsible GP partner as well.
- If a locum is issued with a prescription pad, it must be returned to the practice when their locum period is completed in the surgery.
- Single Sheet Prescription Forms:
- Single sheet prescription forms should be afforded the same security as prescription pads. A box of prescriptions contains 2000 sheets. A case reported in 2006 identified an incident where 4 boxes went missing and the NHS Counter Fraud Team estimated that the 8,000 sheets could produce a loss in financial terms of £4.3 million.
- Practice staff who are responsible for prescribing must always use their individual password and never share this with other members of staff.
- When a GP leaves their room unattended they must never leave their computer logged into the clinical system the same is true if you leave a patient unattended in a consulting room.
- This can be done easily by pressing Ctrl Alt Delete and then selecting the lock screen option, or by pressing the Windows and L key together.
The LMC would suggest all Practices review their procedures.
The following checklist may be helpful:
- Responsibility for the ordering of prescription pads and boxes of blank prescriptions is restricted to a small number of people;
- Prescription pads or boxes of blank prescriptions are be checked against the number ordered as soon as they are received at the practice;
- The serial numbers of the prescription pads are recorded;
- Prescription pads and the boxes of blank prescriptions are stored in a secure place;
- If a new supply is requested or given to a clinician, the serial numbers of the prescription pad are recorded;
- GPs are informed that they cannot simply access the store and take prescription pads without recording the required information;
- Locums have unique identifiable passwords for the practice’s clinical system;
- The practice has a policy for issuing FP10s to locums and what is issued is recorded;
- All GPs follow the advice about storage of FP10s for home visits;
- The Information Governance requirement about the security of NHS smartcards and computers systems when a clinician leaves a computer unattended has been reinforced;
- The practice has a policy for the action required if a prescription pad were to be stolen (attached is a model LMC policy which your practice could use or adapt);
- GPs are reminded that they must not prescribe for themselves or their family even on a private prescription.