Improvements in medication change communication

The Interface Group identified ongoing confusion about how medication changes in secondary care should be communicated to primary care, and whether Formstream or clinic letters should be used. 

Inconsistency in how changes were communicated created disputes about what constituted an acceptable request route. It also introduced risk, as clinic letters could take anywhere from a few days to several weeks to reach primary care colleagues, which was unsafe for urgent medication changes.

To resolve this, the Interface Group agreed a practical set of rules to be used across NHS Highlands that could be applied consistently across the system:

• For urgent medication actions that need to be completed within 24 hours, a prescription should be given directly to the patient by secondary care. 
• For changes that need to be actioned within seven days, changes should be sent through FormStream. 
• For routine changes, clinic letters should continue to be used, with a clear 'ask' highlighted at the top of the letter so the action required is immediately visible.

The Interface Group also agreed to standardise a 'Highlight to GP' section in clinic letters. This shared approach has reduced uncertainty, improved safety and created a clearer, more reliable process for communicating medication changes across the interface.

For more information on this case study, please contact scotland.interface@rcgp.org.uk