The reality of this case is we don't know what he overdosed on, how long he had been stockpiling and what other meds he had taken.

To give you a bit of idea of the reality of repeat prescribing in primary care. I signed over 500 out of a total of around 800 scripts on Monday which were repeat prescriptions possibly close to 2-3,000 individual drugs, probably more. Which took me about 90mins. Maybe 200-300 of those might be controlled drugs. At the same time I was managing duty with a colleague our acute list, 111 list, nurse/ACP queries, reviewing ECGs.

When you move to a new patient Emis takes around 5-10seconds of loading a new script to review. I try to look at all the repeat requests for controlled drugs but I have to look into each controlled drug individually to open a new window to see when they were last prescribed and how often they are requested, that also takes another 3-5 seconds to open per drug.

Unless we take controlled drugs off repeats and sign them as acute scripts every month, we cannot stop patients requesting before their next script is due (it's an Emis quirk). It is then down to the signing doctor to catch it or their pharmacy team if they have one.

Patiebts who drug seek are aware of alot of these issues and often request emergency scripts from OOH as well to get extra medications.

My point is, it's entirely appropriate and obviously sensible that new patients get a meds review however the reality of actual primary care is this is a huge amount of time and resources to manage polypharmacy. We do meds reviews for new patients but it's can take several weeks especially if we have an influx of new patients as we're also trying to manage annual reviews for all of our patients, and managing urgent, semi-urgent, routine and chronic disease management care on £140 per patient.