A day in the life of a Prescription Clerk

Posted by: Mark - Posted on:

At Fountain we have 2 full-time prescription clerks, we work as a team led by the Clinical Pharmacist and are supported by PCN pharmacist. Our working hours rotate to allow us to cover the surgery’s extended opening hours.

Typical early shift… Alarm goes off 6.50am, get up sort out home stuff, set off to be at our desk 8am ready for the day. Most days our routine is the same although when we work a late shift it can be slightly different as pick up from the early starter, so it goes like this…

After entering the building, we check all the post boxes downstairs in reception for any paper requests which have come in from the day before coming upstairs and log on. The paper requests are are collected from reception at lunch and before close of day, these paper slips come from patients and pharmacies and can be up to 600 per day, they are processed in the order they are collected usually within 48 hours.

First job is to check the Urgent tasks from the day before, these can be from other teams, GP’s, Pharmacies, Midwife, District Nurses or Hospital. Once actioned we move to the online requests these average around 300 per day. These are patient requests sent through who have registered with the Online Service, this is a fantastic system and is much more productive for us to process as than little bits of paper! To register simply confirm your details with reception who will issue a  username and password – it seems daunting, but it is easy once set up, our oldest online user is 87 years old!!

Our phone lines open from 10-4pm, this is a dedicated line for prescription queries, please note due to safety we do not accept requests over the phone. The prescription Clerks can only issue medications on repeats. If the items are not on your repeats you will be directed to book an appointment with a clinician. We are happy to help with other queries you may have!

We receive Treatment advice notes from Hospital and other services such as Living Care Health Services, One You Leeds.  We usually allow up to 7 days to process these, but most are done much quicker and if you have a mobile number on the system, we will send a message once this has been processed and sent to GP for signing. Many prescription items need regular blood monitoring to ensure safe to continue part of our role is to check these bloods have been done and if done at the hospital we have download bloods from their system to ours.

At 10am the phone lines open, the calls range from patient’s calling to ask if their script is ready, local pharmacies queries, hospital queries, online pharmacies, appliance contractors, patients who have not received scripts for any reason, patients are requesting early, lost medication, cannot get to surgery to order, new items from outside services to be issued, checking letters have come in from other services with new medication to commence, re-set of online service, care homes requests, patient’s form supported living queries, the list goes on.

During the morning we also have a prescription query list which we work closely together with the Clinical Pharmacist and Duty Team. This can be several things ranging from E-Consults which don’t need Clinical input, queries form the Reception Team regarding medication, or things that we have come across that needs discussion and review by a Clinician. This is a great way for us to learn more, and look at things more from a clinical perspective, increasing our knowledge and gaining more experience to looking at reviewing patient’s in a different way than just medication.

These things normally take us up to lunch time.  At 12 noon we distribute all the scripts out to the GP’s in surgery that day for signing for the afternoon. Prescriptions are sent electronically to a patients’ nominated pharmacy. Gp’s will work through signing during the afternoon in between clinics, home visits, task and writing referrals. At 12.30 we post any letters and recheck the boxes again for paper requests.

Then its lunch time, we like to go out for lunch to get some fresh air and away from our desks, either a little walk round Morley or we go home to stretch the dogs legs and feed them or just take time out at home relaxing. We always  have staggered lunches to cover the desk and phone lines.

In the afternoon we have the same routine again, when processing scripts we have to be very proactive with checking patient reviews are up to date, we send messages to book in or if very overdue we would call and make the appointment over the phone. We check patients are up to date with bloods for Warfarin, Amber Drugs, Thyroxine Medication, if these are not in date this could affect you receiving your medication. Once a patient is up to date with all reviews and medication and fulfil a certain criteria we can set up Repeat Dispensing, this is where normally a full year of scripts is sent to the pharmacy which is available monthly or two monthly depending on the cycle, which makes it a lot easier for everyone all round, no ordering for patient’s and no processing for us. Unfortunately, this is only used for certain medications and is not suitable for controlled drugs.  We  have a number of patients who we monitor and have control over the issuing of scripts weekly, this is to help and support them, some patients have weekly or monthly dosette from local pharmacies again to which we work closely with them for ordering purposes. 

We have set up a local What’s App group for all the pharmacies in the area which we keep up to date issues with medication out of stock, pharmacies also can message each other if they are struggling to find certain medication / drugs so it works well. We speak to lots of different people on the phone for lots of different reasons, we do have close contact with a number of elderly, vulnerable patients who we try to support with medication queries.  Some patients have to order catheters or stoma products which can be very complicated with order codes,  this way of life maybe new to them and can be very daunting, they maybe just out of hospital and doesn’t know what they need.  In this instance we try to help as much as possible and maybe sometimes have input from the Stoma Nurse, Incontinence Team. We work closely with the District Nurses, Palliative care team, CAMHS, Leeds Mental Health services for new medication etc

As prescription clerks we have a lot of experience within the surgery having had different previous roles within the surgery. They are happy to support and share  knowledge to try resolve problems and medication queries.

We also liaise with the GP’s, ANP’s, PA’s, practice nurses and care support workers who we work together for advice with many things including reviews, scripts, medication alternatives, injection information, help and support are always there when we need them.

There are many other admin jobs which we also do during the day, we send letters out on behalf of the Clinical Pharmacist for potential new meds / reviews, we have to keep up with shredding all the paper requests which we keep for a month for audit purposes, open and action the postal requests. We also can help patients whose medication is not in line with a synchronisation form in which the patient has to count their medication they had at home. We then issue a one- off prescription with odd quantities to bring the medication inline, this helps them order only once per month and reduces chance of running out and multiple visits to the pharmacy.

We also run a report monthly called Neptune which highlight patients who have not attended bloods monitoring for specific types of medication, this involves running reports, inputting relevant data. We then send letters or contact patient’s for blood appointments, also making sure the patient record is up to date with weight, lifestyle information, this is crucial to keep up to date for these patient’s as again be clinically detrimental if medication is issued wrongly.

The day goes by so quickly, as you can see there is always something for us to do – it never stops. At 4pm its home time for one of us. The other clerk works from the ground floor office (at the back of reception) and we deal with any prescription queries face to face. The majority of our work is not not face to face but we are happy to come down to the reception to help with any patient queries.. We have a great team ethic in here and have amazing relationships with everyone in the building including the cleaners, we have great support from the Clinical Pharmacist, and are always looking for ways to improve, we have gained so much knowledge to enable us to evolve ourselves in this role. We also get first class support from the PCN Pharmacist  GP’s and ANP’s! We don’t stop and our brains are sometimes frazzled when we go home but we can actually put our hands in the air and say “We Love our Job, we have helped people today”, and this is our day in the life of a prescription clerk, thank you for reading!