RCPE Press Release

23 August 2010

The Royal College of Physicians of Edinburgh (RCPE) has, today, called on the Scottish Government to act urgently to reduce the number of prescribing errors in Scottish hospitals and, in turn, improve patient safety.

A recent study found that in a one-week period 5.9% of consultants and 10.3% of Trainee Doctors in UK hospitals had made prescribing errors, some of which could have been potentially fatal for patients [1]. While there can be many reasons why prescribing errors occur, it has been recognised that one of the most significant contributory factors is a lack of standardisation in prescribing charts used by doctors in different parts of the country. The accuracy of these charts is vital to ensure correct medication selection and dosing, to avoid potential adverse interactions with other prescribed medicines and to inform clinical decision-making about treatment options. Prescribing charts developed by individual Health Boards can vary significantly, thus increasing the risk of prescribing errors as doctors (particular those in training) move from hospital to hospital and use inconsistent prescription recording systems. In recognition of this, the NHS in Wales introduced a national prescribing chart for Wales, with associated prescribing standards, in 2004.

The RCPE has recently compared prescribing charts currently in use across Scotland and is concerned that local charts, lacking standardisation, are still in use, contributing to prescribing errors and compromising patient safety. Coupled with data suggesting that almost 1 in 9 hospital prescriptions contain errors [1] and that the development of a national prescribing chart, with associated standards, would address the ambition to eradicate "avoidable injury or harm from healthcare" signalled in the Scottish Government's Quality Strategy [2], the RCPE believes that it is now time for the Scottish Government to commit to introducing a national prescribing chart.

The adoption of a standardised prescribing chart also offers the opportunity to support other quality improvement measures, including the implementation of nationally agreed clinical guidelines. For example the inclusion within standardised prescribing charts of regular screening for Venous Thromboembolism (VTE) risk (the development of blood clots within veins) would ensure patients were regularly monitored throughout their stay in hospital. Currently 25,000 deaths a year are attributed to VTE across the UK [3] and a prominent reminder on a standardised drug chart would ensure patients are screened regularly and receive appropriate and timely interventions.

Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh (RCPE), said,

“Prescribing errors can and do occur. The adoption of standardised prescribing charts is a simple but effective way of supporting quality improvement and protecting patients. It would also facilitate and reinforce teaching of medical students and junior doctors. Local variation in prescribing charts has existed for many years, but has not been addressed by successive governments and should now be given greater priority. Putting it simply, patients should expect a standardised system of prescribing regardless of which hospital in Scotland they are treated.

“Prescribing charts offer an ideal opportunity to identify patients at risk from serious but avoidable complications in hospital. Risks such as venous thromboembolism resulting from bed rest, immobility and pre-existing medical conditions should be assessed regularly. Adding a risk scoring system to a standardised prescribing chart would help to ensure all patients benefit from such screening.

“Doctors also frequently move around the NHS within the four home countries of the UK. It would, therefore, be logical to follow Wales’ example by developing a national prescribing chart for Scotland initially and then to work towards a UK-wide prescribing chart for use across the whole of the NHS”.


Contact: Graeme McAlister on 07733-263453 or 07808-939395


1. ‘An in-depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education’ (study commissioned by the General Medical Council (GMC)), December 2009

2. The Healthcare Quality Strategy for Scotland, The Scottish Government, May 2010

3. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality.