Open-loop prescribing
Repeat medicines
Where repeat supply continues despite excess stock, dose changes, discontinuation or weak reconciliation.
Question
Was this medicine still needed when it was dispensed?
Resource intelligence principle
Do not assume activity is waste. Connect the data, identify the signal, validate it clinically and operationally, then measure what can actually be recovered.
Observed
What we have found
- Historic national waste estimates are still being cited because continuous national measurement is weak.
- Repeat prescribing, dispensing and actual consumption are not always joined into one closed loop.
- Dose changes, hospital discharge changes and excess stock can create avoidable supply if records are not reconciled quickly.
Intervention
What we would test
- Estimate remaining stock before the next repeat supply.
- Flag discontinuations, dose changes and duplicate supply before dispensing.
- Use pharmacist or clinician review for any intervention rather than autonomous stopping.
- Measure avoided supply in pounds and items, then verify whether the intervention was appropriate.
Pilot measurement
What success must prove.
Observed
What actually happened?
Avoidable
Which part could plausibly have been prevented?
Recoverable
What safe intervention exists?
Verified
What changed after implementation?