Last reviewed 16 November 2020

The Local Government Association (LGA) and NHS England have published a new step-by-step guide for Care Quality Commission (CQC) registered care homes, GP practices and pharmacies, which includes the tools required to set up a faster, safer way to order medicines for care home residents.

The guide has been created to support best practice for care homes, GPs and pharmacists to work together to allow care home staff to order online repeat medication on behalf of residents.

The facility is called "proxy access" and was developed to allow someone other than the patient to access and manage parts of their GP online services account. Pilots of the proxy access system found benefits including fewer risks and issues associated with ordering, issuing, collecting, and dispensing repeat medications; fewer errors and queries; improved clinical safety; easier and faster access; easy to access an audit trail; and improved data security.

The proxy is given their own online access account as opposed to using the patient’s login details, and is typically used by the parents of young children and recognised carers of adults.

Only proxy access to repeat medications can be set up by GP practices, so that care home staff cannot have access to the rest of the medical record. However, if a resident does not want care home staff to have proxy access to any part of their record, including repeat medication, the care home must continue using a paper-based process.

When staff in the care home are given proxy access by the GP practice, they can order repeat prescriptions and include a note to the GP practice. This may be particularly useful when an item is marked on the GP system as needing to be reviewed with the patient.

An audit trail is kept in the GP system when a proxy accesses a patient’s record. For repeat prescriptions it records who accessed the record and when, what medication was ordered, and who authorised or rejected the request and when.

The guide, Ordering Medication Using Proxy Access: Guidance for Care Homes, GP Practices and Community Pharmacies, is available at www.england.nhs.uk