Nice GP antibiotic guidance pointless until locums have unique prescriber number

Nice have published their draft guidance on antimicrobial stewardship, which includes a plan to release personalised prescribing data to GPs.

Resistance to antimicrobials is increasing, and alongside global-scale prescribing to animals in the farming and veterinary industry, and over-the-counter prescribing in other countries far more populous than the UK, GPs are being seen as a potential way to reduce this problem.

But just how useful will these reports be? Could they in fact do harm? It doesn't look like Nice quite appreciate the issues. In the draft guidance, on the subject of how locum prescribing could skew data:

"Currently GP prescriber codes are linked to the BSA individual cost centre rather than that of individual prescribers (for example, locums, who are not working permanently in a location, often use a ‘general’ prescriber code in 1 practice for all of their prescribing). Prescribing data do not therefore always just represent the GP name assigned to that code or cost centre."

Nice antimicrobial stewardship: draft guideline 7.6 Evidence to recommendations page 81

Some points for Nice

  • NASGP estimate that there could be anything up to 17,000 GP locums prescribing in the UK.
  • We know of no situations where a locum GP has her own prescribing number that can be transported to any other practice.
  • In general, we GP locums always prescribe using another GPs prescribing number.
  • It's unusual for a GP locum to be given their own unique username and password when signing in to the patient record.

So, should GPs be given personalised antibiotic prescribing data? Yes, absolutely. But create a level playing field first by enabling our locum GP colleagues to have the same access to those NHS structures and processes that have patient and public safety at heart.

3 Responses

  1. S Cotes
    It continues to amaze me that not only do Locum GPs have no prescriber number but this is also the case for Salaried GPs. Surely all GPs or possibly all Drs should have their own prescriber number and access to NHS prescriptions. In the past I have worked in Australia, I was issued with a prescriber number as I started work in the ED. It is impossible to have accountability without being able to identify the prescriber.
  2. Martin Stagles
    And in the Practice where I am (ongoing, my choice) locum, over half the patient contacts are with locums. However, we do each have our own username and password for the computer system, apart for 1 or 2 who were very short-term.
  3. Christine Paterson
    I prescribe as a Locum GP in the NHS on someone else's prescriber No. I also prescribe as an Army Reservist Medical Officer on no number at all. And, lastly I prescribe as a Locum Civilian Medical Practitioner for the Army without any number. Therefore the Nice guidance have completely failed to capture my prescribing at all.

Leave your comments