Repeat Prescribing Toolkit: supporting safer, more efficient repeat prescribing in primary care

Summary

Health Innovation Kent Surrey Sussex (KSS) helped medicines optimisation teams across our regions to introduce the Repeat Prescribing Toolkit (RPT) in primary care to help tackle inefficiencies, potential safety risks and reduce medicines waste. Through workshops, tailored system support and practical tools, we helped teams understand variation in repeat prescribing and identify priorities for improvement. Early results suggest greater consistency, improved confidence across primary care teams and progress in addressing medicines oversupply and safety risks.

Challenge

The 2021 National Overprescribing Review estimated that at least 10% of medicines are overprescribed, leading to avoidable harm and unnecessary spending. Prior to the toolkit, there had been no updated national guidance on repeat prescribing for two decades.

Approach

Developed by the Royal Pharmaceutical Society (RPS) and the Royal College of General Practitioners (RCGP), the Repeat Prescribing Toolkit introduces a structured self‑assessment and collaborative approach to safe and effective repeat prescribing. This helps general practices and primary care networks identify variation in processes and target areas for improvement.

We helped integrated care boards (ICBs) to introduce and apply the Repeat Prescribing Toolkit in ways that reflected local priorities and delivery models, by:

• Delivering three multi‑stakeholder “lunch and learn” workshops hosted by Health Innovation KSS, and featuring Clare Howard, Clinical lead, Co-chair, FRPharmS and Fellow of the RPS and lead author of the toolkit
• Providing a locally adapted repeat prescribing oversupply dashboard to support practices and systems to identify areas of concern and track change over time
• Offering tailored support aligned to local commissioning and incentive schemes

The approach varied by ICB:

• Surrey Heartlands* focused on inhaler oversupply and monitoring as part of its 2025‑26 prescribing incentive scheme. Participating practices were required to attend one of our workshops.
• Sussex* implemented a prescribing scheme with locally agreed measures in place to capture the quantitative and qualitative impact. We delivered face-to-face training to ICB project leads and medicines optimisation technicians. This allowed them to cascade training to practice admin and prescription teams. In addition, we promoted the “Only Order What You Need” patient‑facing campaign.
• Kent and Medway piloted more direct, practice‑level support. We worked with the ICB to identify suitable practices and provided project management support to pharmacy technician leads, introductory workshops, help with self‑assessment and action planning, and support to capture feedback and early impact.

Impact

The work is at different stages of delivery across our local health systems, and a full learning report is due in July 2026. Early evidence and routine prescribing data suggest reductions in oversupply.

Across all systems, feedback and emerging learnings point to:

• Increased confidence and understanding of repeat prescribing processes among clinical and non‑clinical staff working in primary care.
• Clearer roles and responsibilities within practice teams, including administration teams, such as prescription clerks and receptionists.
• More consistent approaches to monitoring and review of repeat medicines.

Lauren Birzu, Medicines Optimisation Pharmacy Technician (East Sussex) said: “The repeat prescribing domain introduced a more personalised, practice-led approach, creating a positive experience for the workforce and improving practice relationships. It was encouraging to see practices so engaged and proactive in improving their processes and their commitment to enhance both patient experience and staff efficiency.”

Spread and scalability

The toolkit can be adapted to different system contexts, incentive schemes and workforce models. We will share a learning report and an implementation guide to support further roll out.

The Repeat Prescribing Toolkit is designed as an ongoing improvement resource rather than a one‑off intervention. Learning to date highlights the benefits of addressing one area at a time, using quality improvement approaches such as plan‑do‑study‑act cycles, and embedding review of repeat prescribing into business‑as‑usual processes.

Find out more

More detail on how we introduced the Repeat Prescribing Toolkit to primary care teams.

Notes

*On 1 April 2026, NHS Sussex ICB merged with NHS Surrey Heartlands ICB to form a single regional health authority known as NHS Surrey and Sussex ICB.