A CALL has been made to remove the requirement for GPs to physically sign prescriptions which could then free up time which could be put to better use.

Dr Andrew Buist, chairman of the British Medical Association in Scotland’s GP committee, has written to the Health Secretary Jeane Freeman asking for this requirement to be changed, but as it is a reserved matter the legal change would have to come through Westminster.

He says he hopes it is something which could be raised in a second round of emergency legislation stemming from the coronavirus outbreak.

He said GPs use an electronic system for most aspects of prescribing from keying in details in a computer to printing out a prescription. However, they then find themselves signing in ink around 200 pieces of paper on a daily basis which Dr Buist believes is a step which could be removed.

Dr Buist said: “Every prescription requires an ink signature and doctors are signing 100 to 200 every day. There is no added value in it at all and we really should be making the move to entirely paperless prescriptions from a GP point of view. The patient would still either be able to pick a prescription up or it could be put into a pharmacy.

“I wrote to Jeane Freeman in the hope that this could be a priority during these times. It is a reserved matter and the response was that this would have to be taken up on our behalf with Mrs Freeman's equivalent Matt Hancock, at the Department of Health.

“Even before Covid-19 came up this was not a good use of GPs time and was something that we could remove.”

Read more: Coronavirus in Scotland: Fear reluctant patients are dying of other causes

Dr Buist reinforced the message that GP surgeries are open for business and people should not put off coming to see them. Earlier this week Interim Chief Medical Officer Dr Gregor Smith said he was concerned by a 72 per cent fall in urgent referrals for suspected cancer during the outbreak. He said cancer sufferers may be going undiagnosed because they are not seeking help from their GP during the coronavirus crisis.

He said: “It leaves me worried that there are people out there who are not seeking help from their GP when they might need it.

“If it was urgent before Covid-19 it remains urgent now.”

Dr Buist added: “One of the main things to stress is that we are open for business as normal from 8am to 6pm across the country, but it is different and it feels different. We are all wearing theatre scrubs and we are doing an awful lot more consultations over the phone and video telephone consultations.

“We are now having to wear personal protection equipment for seeing patients face to face as we would be within two metres if we need to examine someone. They might come in with symptoms that are not obviously Covid-19 but we would still be wearing a mask, apron and gloves.

“We are doing more consultations without having to see the patient first. If they are worried about a skin lesion we would ask them to send a picture electronically which allows us to take a look to see if further action is required or whether they need reassurance that it is ok.”

Contact was made with patients falling into the shielding group that if they were to contract the disease could fall seriously. Nationally 1.5million letters were sent out but this was also backed up with checks by GP surgeries.

Dr Buist added: “We also ran searches on our own databases to ensure no one had been missed. We had about 250 from my own surgery in Blairgowrie who we needed to contact to talk about anticipatory care planning if they were to become seriously ill. It would include how and where they would want to be treated and this would all be detailed in their notes in case there was an emergency at 3am on a Saturday for example.

“Our advice to GPs is also be prepared to talk about end of life care if it is raised by the patient. Some doctors have perhaps been a bit overenthusiastic, but what we are saying is that if the patient wants to talk about that with you then you have a strong reason to do it.”

Read more: Coronavirus: Death rate from Covid in England is nearly twice as high as Scotland

Dr Buist added that the sudden rush for repeat prescriptions and stockpiling of medicine three or four weeks ago seems to have abated.

“There is no shortage of medication. Clearly if everyone was to put in double orders to wouldn’t work as the supply chain isn’t designed to cope with that. We saw some people with asthma who hadn’t used inhalers for years put in orders. I think people were just trying to get prepared,” he added.

Dr Buist said GP surgeries have seen lighter numbers than usual.

He added: “One of the messages we are putting out there is that while advice is to stay home, if you have serious concerns then you must contact us by telephone and if necessary would be offered a face to face appointment if it is appropriate.”

Virtual appointments with video link ups with patients has been used more during the crisis.

Last year patients in Lanarkshire were among the first in Scotland to trial “virtual GP consultations”, which involves an appointment conducted via video call, similar to Facetime.

The “Attend Anywhere” technology gives patients the option to attend an online appointment from their computer, smartphone or tablet, instead of travelling to a physical doctor’s appointment. And it is now being used more widely.

Dr Buist said: “During this time more of us are holding meetings online and video appointments are being held, but it also highlights the difference in broadband cover in areas. If this is one of the ways we go down, and I think we should be, then for rural areas in particular the broadband connections need to be in place."

A Scottish Government spokesman said: “In Scotland, a sufficient authentication solution and integrated IT system in GPs and pharmacies is currently being explored. Provisions relating to prescription requirements are reserved to the UK Government. Following a previous meeting with Dr Buist, the Health Secretary wrote to the UK Health Secretary asking him to remove the requirement for prescribers to sign prescriptions during the COVID-19 pandemic, in order to minimise the workload on GP practices during this time of unprecedented demand. A response has not yet been received.”

The Department of Health at Westminster was contacted for comment.

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