There was an error in 8.9% of medication orders written in 19 acute trusts, according to the results of a study commissioned by the General Medical Council (GMC). Â Almost all errors were spotted and corrected by others before they could affect patients, all grades of doctors made prescribing errors, the drugs most often involved were analgesics, antibacterials, bronchodilators and antianginals, and admission was the most common time for errors to be made. Foundation year one doctors actually had a slightly lower error rate (8.4%) than doctors overall.
Among its recommendations, the GMC proposes that a standard prescribing chart should be introduced throughout the NHS. The Medical Schools Council has supported this suggestion: its Chair, Professor Tony Weetman, said that “…..it would be a simple additional measure to improve the consistency of the teaching of prescribing skills by Medical Schools”.
The British Pharmacological Society (BPS), however, is less impressed: Â “the GMC appears to be maintaining the position that training is not a core issue to be tackled”. Professor Simon Maxwell, Chair of the BPS Prescribing Committee said, “Like everyone else, I am extremely concerned by this error rate but I am dismayed at the suggestion that improved education and training is not a central part of the solution”. He believes that a national form would only be one part of the solution to “a much more profound problem”.
The report’s recommendations include targets on: clinical working environments including a standard national form; undergraduate medical education programmes; Foundation year 1 education; other parts of the medical education continuum; and interprofessional education.
The report also includes some systematic reviews, in which a slightly lower error rate was found (median 7%) and in which errors were most common with antimicrobials. Incorrect dosage was the most common type of error and errors were more common in adults than children.
The report also says that doctors relied heavily on pharmacists and nurses to identify and correct errors and that a ‘safety culture’ was ‘conspicuous by its absence’ from respondents’ discussions of their prescribing errors, the reported culture of their working environments, and the reported actions of other doctors.