Preventing prescribing errors with PINCER

This programme of work is one of seven programmes selected for national adoption and spread across the AHSN Network during 2018-20.

Prescribing errors in general practice are an expensive, preventable cause of safety incidents, illness, hospitalisations and even deaths. Serious errors affect 1 in 550 prescription items, while hazardous prescribing in general practice contributes to around 1 in 25 hospital admissions.

In 2017 the World Health Organisation (WHO) launched a Global Patient Safety Challenge: Medication without Harm with the aim of reducing the level of severe, avoidable harm related to medicines by 50% over the next 5 years, globally. 

In Kent Surrey and Sussex we are working to increase the use of Pharmacist-led Information technology intervention for reducing Clinically important Errors (PINCER) to meet this challenge. 

PINCER helps tackle these issues, by supporting GP practices using software systems alongside root cause analysis to identify why mistakes happened.

In the region where it began 2.9 million patient records have been searched and 21,636 instances of potentially hazardous prescribing have been identified using 11 prescribing indicators – it is estimated that approximately half of these needed an intervention to avoid harm, cases that could otherwise have been missed.

Preliminary results show that as a result of the study there was a significant reduction in hazardous prescribing for indications associated with gastrointestinal bleeding, heart failure and kidney injury.

It has now been spread to other parts of the country and is currently having further detailed evaluation of the implementation.  It is anticipated that use of PINCER will result in fewer medication-related hospital admissions and cost savings to the NHS.

Further reading

Video - How to use the PRIMIS PINCER prescribing audit tool in primary care