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Prescribing guidance: Remote prescribing via telephone, video-link or online

60. Before you prescribe for a patient via telephone, video-link or online, you must satisfy yourself that you can make an adequate assessment, establish a dialogue and obtain the patient’s consent in accordance with the guidance at paragraphs 20–29.

61. You may prescribe only when you have adequate knowledge of the patient’s health, and are satisfied that the medicines serve the patient’s needs. You must consider:

a. the limitations of the medium through which you are communicating with the patient

b. the need for physical examination or other assessments

c. whether you have access to the patient’s medical records.

62. You must undertake a physical examination of patients before prescribing non-surgical cosmetic medicinal products such as Botox, Dysport or Vistabel or other injectable cosmetic medicines. You must not therefore prescribe these medicines by telephone, video-link, or online.

63. If you are prescribing for a patient in a care or nursing home or hospice, you should communicate with the patient (or, if that is not practicable, the person caring for them) to make your assessment and to provide the necessary information and advice. You should make sure that any instructions, for example for administration or monitoring the patient’s condition, are understood and send written confirmation as soon as possible.

64. If the patient has not been referred to you by their general practitioner, you do not have access to their medical records, and you have not previously provided them with face-to-face care, you must also:

a. give your name and, if you are prescribing online, your GMC number

b. explain how the remote consultation will work and what to do if they have any concerns or questions

c. follow the advice in paragraphs 30–34 on Sharing information with colleagues.

65. You should not collude in the unlawful advertising of prescription only or unlicensed medicines to the public by prescribing via websites that breach advertising regulations.21

66. If you prescribe for patients who are overseas, you should consider how you or local healthcare professionals will monitor their condition. You should also have regard to differences in a product’s licensed name, indications and recommended dosage regimen. You may also need to consider:

a. MHRA guidance on import/export requirements and safety of delivery,

b. whether you will need additional indemnity cover

c. whether you will need to be registered with a regulatory body in the country in which the prescribed medicines are to be dispensed.