1. Purpose
A single-handed independent specialist often prescribes privately, sometimes without the patient's GP knowing, and sometimes remotely. That carries real risks: an interaction the prescriber does not see, a controlled drug misused, or a medicine that needs monitoring no one is doing. This policy sets out how the practice prescribes safely, issues private prescriptions correctly, and keeps the patient's wider care joined up.
The practice must verify this policy against current GMC prescribing guidance and the Human Medicines Regulations 2012 before adoption.
2. Sources to verify before adoption
- GMC, Good practice in prescribing and managing medicines and devices: https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/good-practice-in-prescribing-and-managing-medicines-and-devices
- The Human Medicines Regulations 2012: https://www.legislation.gov.uk/uksi/2012/1916/contents
- The Misuse of Drugs Regulations 2001 and controlled-drug prescription requirements: https://www.legislation.gov.uk/uksi/2001/3998/contents
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (safe care and treatment): https://www.legislation.gov.uk/uksi/2014/2936/regulation/12
3. Scope
This policy applies to:
- all prescribing by the practice, including private prescriptions, controlled drugs and remote prescribing
- the doctor who prescribes and any staff who support prescribing
- the patients prescribed for
4. Prescribing within competence and on adequate information
- the doctor prescribes only within their competence and for conditions they are managing
- before prescribing, the doctor has enough information about the patient, including their other medicines, allergies and relevant history, to prescribe safely, and checks for interactions and contraindications
- the doctor does not prescribe simply because a patient requests a medicine; the decision is a clinical one
5. Private prescriptions
- private prescriptions are written correctly and legibly with the information the law requires, and dated and signed
- the patient is told what the medicine costs them and where they can have it dispensed
- the practice keeps a record of what was prescribed
6. Controlled drugs
Where the practice prescribes controlled drugs:
- the additional legal requirements for controlled-drug prescriptions are met
- the practice is alert to the risk of dependence, diversion and misuse, and prescribes cautiously, especially for opioids and other drugs of dependence
- the practice records its controlled-drug prescribing and follows the controlled-drug governance that applies to it
7. Keeping care joined up
Because a single-handed specialist may be one of several people prescribing for a patient:
- the practice asks the patient's consent to tell their GP what has been prescribed, and where the patient agrees, does so promptly, so the GP record is complete and interactions can be seen
- where the patient declines, the practice records that and is especially careful, because no one else may know what has been prescribed
- the practice does not assume the GP will take over monitoring it has not agreed with them (see the shared-care arrangements in the scope, indemnity and continuity policy)
8. Remote prescribing
Where the practice prescribes remotely, it does so only where it can make a safe decision without examining the patient, gathers enough information, and does not prescribe medicines (such as some controlled drugs) where remote prescribing is not appropriate. The basis for a remote prescription is recorded.
9. Repeat prescribing and monitoring
A medicine that needs monitoring is prescribed only with the monitoring arranged and tracked, and a repeat is not issued where monitoring is overdue. The practice does not run open-ended repeats without review.
10. Recording
The practice records, for every prescription: the medicine, dose and quantity, the indication, the information the decision was based on, any remote-prescribing basis, and whether the GP was informed. The record shows the prescription was safe and considered.
11. Audit cadence
The practice checks, on a stated cadence, that:
- prescribing was within competence and based on adequate information, with interactions checked
- private and controlled-drug prescriptions met the legal requirements
- the GP was informed with consent, and shared monitoring was arranged not assumed
- remote prescriptions were appropriate and recorded, and monitored medicines were not repeated on overdue monitoring
The doctor and the Registered Manager review the results and record the improvement actions that follow.