Scale up, replication and licensing of the PINCER intervention

University of Nottingham

  • Run by the University of Nottingham.
  • Being implemented in general practices across England.
  • Aiming to reduce common medication errors in general practice, make primary care prescribing even safer for patients.
  • This project is scaling up and spreading a proven pharmacist-led intervention that supports pharmacists and pharmacy technicians, working with GP practices, to identify cases of potentially hazardous prescribing, resolve issues and prevent their future recurrence.

In a recent study, prescribing errors were identified in 5% of prescription items, with one in 550 items containing a severe (potentially life-threatening) error. This equates to around 1.8 million serious prescribing errors in English general practices each year. 

PINCER is a successful pharmacist-led information technology intervention for reducing important and common medication errors in general practice prescribing. It has been incorporated into national guidelines on medicines optimisation from the National Institute for Health and Care Excellence (NICE) and NHS England. 

PINCER involves clinical pharmacists and pharmacy technicians working with GP practices to identify cases of potentially hazardous prescribing of medicines associated with increased risk of gastrointestinal bleeding, exacerbation of asthma, worsening of heart failure, stroke and acute kidney injury. Patients are identified using the PRIMIS PINCER Tool

The pharmacists feed back to the GP practices, using the principles of educational outreach and root cause analysis, and work with them to build and implement an action plan to resolve issues identified and prevent future recurrence. 

The PRIMIS tools can also be used to generate charts that show comparative data for numbers of patients at risk at GP practice, clinical commissioning group, academic health science network and national levels.

Although the PRIMIS PINCER tool has been used in more than 2,000 practices since February 2013, the aim of this project is to develop a clearly defined strategy for scale and spread of this proven intervention. The project team’s vision is to make primary care prescribing even safer for patients. 

Contact information

For more information about this project, please contact Tony Panayiotidis, Project Manager, Business Implementation Lead, PRIMIS.

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