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Prescription direction

Note: While this scenario focusses on a doctor who had commercial interests in a pharmacy, it could also apply to a range of healthcare professionals who may have a direct or indirect financial interest in another business, regardless of the ownership model.

The scenario

Dr Williams is a GP in a private practice. Her employer has recently bought a local pharmacy. Dr Williams has been told to encourage her patients to take their prescriptions there as they will get better service and faster processing times.

What did Dr Williams consider?

Dr Williams considered whether her patients may think that her employers were influencing her judgment as they had a financial interest in the pharmacy. Dr Williams knew she must always put the interests of her patients before her own or her employer’s interests, and that she must ensure her professional judgement was not compromised. She was aware that her patients could choose freely which pharmacy dispenses their prescriptions and so she decided it wouldn’t be appropriate to make recommendations.

What did Dr Williams do?

Dr Williams decided to prioritise the interests of her patients and reminded her employer of her professional responsibilities.

She realised that directing patients to a pharmacy owned by her employer without being honest about this relationship would likely be, or be perceived to be, a conflict of interest. This could damage her patients’ trust in her and in the GP practice.

She decided to make sure her patients understood that they know they can choose where to get their prescription from. Where patients had repeat prescriptions, Dr Williams continued to check with patients that they were happy with their nominated pharmacy, and would advise about a range of options if needed. Dr Williams decided that if any of her patients asked her about that particular pharmacy, she would be open and honest about her employer’s interest in it.

Other useful resources for you

  • Joint statement from the Chief Executives of statutory regulators of healthcare professionals
  • GMC, Financial and commercial arrangements and conflicts of interest, 2013
  • GPhC, Standards for pharmacy professionals
  • GPhC, Standards for registered pharmacies
  • PSNI Code (Professional standards of conduct, ethics and performance for pharmacists in Northern Ireland)
  • NHS Constitution (England) – under this, patients in England have the right to choose their pharmacy
  • For pharmacists working in Northern Ireland, the NHS Constitution doesn’t apply, and pharmacists should follow the BMA guidance on this issue.
  • The 7 principles of public life (‘Nolan principles’ May 1995) – apply to anyone who works in health, education, social and care services and give guidance on transparency and declaring any interests.