• Led by Lincolnshire Community Health Services NHS Trust with the University of Lincoln and East Midlands Academic Health Science Network.
  • Being implemented in up to 17 CCGs across the East Midlands, covering at least 150 general practices.
  • Aiming to reduce medication errors through the use of a proven pharmacist-led information technology intervention (PINCER).
  • Will involve scaling up PINCER, a trial of which showed that it reduced prescribing errors and provided cost savings to the NHS.

Prescribing errors in general practice are a frequent and expensive cause of safety incidents, illness, hospitalisation and even deaths. The rate of errors is estimated to be 5%, with serious errors affecting around 1 in 500 of all prescription items.

These errors can stem from clinical, human and social factors, including knowledge gaps about contraindications, failure to heed computerised warnings, failure to arrange appropriate monitoring and failure of current safety systems to prevent these errors from reaching the patient.

A pharmacist-led information technology intervention for reducing clinically important errors in medication management (PINCER) has been developed to identify and correct prescribing errors in general practices. A cluster randomised trial published in The Lancet showed that PINCER reduced rates of specific prescribing errors by up to 50%. An economic analysis showed PINCER to be cost effective.

The PINCER intervention comprises: practice staff using specific software to identify patients at risk of common prescribing and drug monitoring errors; pharmacists meeting with GPs and nurse prescribers to discuss the results and agree an action plan; and pharmacists working with GP staff to put the plan into action, using approaches such as inviting patients into the surgery and improving prescribing safety systems.

The project will see PINCER spread to at least 150 general practices across the East Midlands by the end of December 2016. It is anticipated that the intervention will result in clinically important reductions in prescribing errors, reductions in medication-related hospital admissions and deaths, and net cost savings to the NHS.