Prescribing Assessment

Prescribing is an integral part of a General Practitioners work and several high profile cases have been published when qualified doctors have made catastrophic errors. In 2017 the GMCs published a document describing Generic Professional Competences. These are competences, which every speciality trainee needs to achieve before the end of training and they include prescribing as one of their key areas. GP trainees are not currently assessed on their prescribing in the workplace and it was felt that this needed to be rectified as a priority.

The assessment consists of a self- assessment prescribing review based on the PRACtlCe study and REVIST studies. These were GMC led reviews looking at the number of times errors were found in prescriptions. The results were alarming with 1 in 20 prescriptions containing an error. The REVISIT study looked specifically at prescribing by GP trainees and the error rate rose further to 1 in 10 prescriptions. The RCGP subsequently worked with the Nottingham team to create an assessment suitable for GPs in training.


The resulting prescribing assessment for GP trainees has now been piloted for the last 2 years. The feedback we have received to date has been positive and both trainees and their supervisors have found it valuable.

Quotes have included:

"An excellent way of spending more time on my prescribing and identifying errors which I didn't think I was making"

"Identifying errors in prescribing could make a big difference to patient safety and treatment success"

"We both found invaluable exercise and generated conversation much wider than just prescribing"

"Useful to see the difference in opinion of what was 'suboptimal' and whether both parties agreed as there were cases that my trainer did not feel there was any suboptimal prescribing even when I thought so myself"

"The most helpful bit for trainee was the two hours we spent reviewing patients and prescriptions. We are planning on repeating audit in April"

"I think this was a useful exercise for my learning"

"We found this was a very beneficial exercise and identified a few trends that had not been picked up due to use of a number of different CSs"

"I always look at prescribing when debriefing but doing a batch enabled themes to appear"

The assessment is a formative exercise to reflect on prescribing practice, which should highlight trends and learning needs within the trainees prescribing. By reflecting on the errors identified it will enable learning plans to be put in place in order to improve prescribing in the future. There is no set standard as it is designed as a learning exercise; however if no errors are highlighted and if no learning is identified this would raise concerns, as to date this has never been the case.

A request was made to the GMC for a mandatory pilot for all full time GP trainees starting ST3 training in August 2019 to complete the final evaluation of the pilot. This has been supported by the GMC. Less than full time GP trainees can still complete the assessment but it is not mandatory for this group.

In recognition of introducing this assessment the number of CbDs required in the ST3 year has been set at a minimum of 10, rather than the current 12.

Full details are below but in summary

  1. The trainee searches on their last 60 retrospective prescriptions
  2. Using the prescribing manual, the trainee 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 trainee completes the trainee reflection form in the ePortfolio and in particular reflects on their prescribing using the GP prescribing proficiencies
  5. The trainee and GP trainer / Supervisor complete the assessment using the GP trainer/ Supervisor assessment form found in the ePortfolio
  6. Both the trainee and GP trainer / Supervisor complete and submit the questionnaires
  7. The trainee uploads the anonymised spreadsheet to their learning log
  8. Supporting documents which outline the assessment in detail can be found below

Documents required to complete the assessment

Questionnaires to be completed

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