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WPBA: Prescribing Assessment

Publication date: 19 January 2024

Prescribing is an integral part of a GP’s work and a key competency that every GP registrar needs to achieve.

The Prescribing assessment is a formative assessment to reflect on prescribing practice, which should highlight trends and learning needs within prescribing. By reflecting on the errors identified it will enable learning plans to be put in place to improve prescribing in the future.

Requirements

The Prescribing Assessment must be completed in ST3.  

The following steps must be followed when completing the assessment:

  1. The GP registrar searches their last 50 retrospective prescriptions and adds these to a Prescribing Assessment spreadsheet – either manually or using one of the automated processes.
  2. Using the prescribing manual, the GP registrar reviews these prescriptions and maps them against potential prescribing errors
  3. The GP trainer / Supervisor reviews 20 of these prescriptions, maps these against potential errors and adds these to the spreadsheet
  4. The GP registrar completes the trainee reflection form in the Portfolio, reflecting on their prescribing using the GP prescribing proficiencies
  5. The GP registrar and GP trainer / Supervisor complete the assessment using the GP trainer/ Supervisor assessment form found in the Portfolio
  6. The GP registrar uploads the anonymised spreadsheet to their learning log

As a formative assessment, there is no way to ‘fail’ the assessment as long as all the above steps are followed. However, the assessment should be repeated if some of the above steps are not completed – such as less than 50 prescriptions being reviewed, no errors being found and mapped, or a lack of reflection.

If the grading for the assessment states that the GP registrar “needs to develop specific prescribing skills to fulfil the prescribing proficiencies”, then they should create a Prescribing PDP. Completion of this could be evidenced by completing a Prescribing CAT.

Documents to support completion of the assessment

How to search for prescription items

Data must be collected for 50 prescriptions. Most GP registrars will be able to use the created searches below to help facilitate the gathering of the data.

If this functionality cannot be used, the assessment of 50 prescriptions must be completed by reviewing consultations in reverse chronological order from a specified date, identifying instances where medication was prescribed. The relevant information must then be manually entered into the spreadsheet.

General Advice on completing the assessment

  • Resources such as the BNF should be used to check that correct prescribing happened, make suggestions for improvement and pick out examples of good prescribing.
  • Responses can be compared with the training resource (XLSX file, 29 KB) available on this page.
  • Both GP registrars and GP Educators should consider if there are any trends or specific learning points to take away

Training resources

The prescribing PowerPoint presentation (PPT file, 3 MB) can be used to explain the new assessment as a large group, making as interactive as possible.

The following resource is a series of 4 documents that shows an example completed assessment form, with consultations, and trainer review and comments included. It includes electronic records for the patients, a random selection of consultations from a full 50 consultations reviewed. Though based on real patients’ various elements and characteristics have been changed to aid anonymity and enhance the educational experience. These have some past medical history (PMH) added and some other medication the patient is already on to model the information available in the real patient records.

Comments from the 'medicines safety and effective healthcare research team from the University of Nottingham, working in partnership with the NIHR GMPSTRC' are also included to provide added value to the resource, and we'd like to thank them for their work on this resource.

Printer-friendly versions of example spreadsheets are also included below:

Background and history

In 2017 the GMC published a document describing Generic Professional Competences outlining broad prescribing skills. This has been updated and reviewed in Good Medical Practice 2024 under the heading “Good practice in prescribing and managing medicines and devices” and gives detailed guidance for doctors relating to all areas of medicines management. 

The RCGP worked with a team from the University of Nottingham to create this assessment, with the aim that it was suitable for GP registrars, based on the PRACtlCe study and REVISiT intervention.

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