Good practice in prescribing and managing medicines and devices

Keeping up to date and prescribing safely

8

As outlined in ‘Good medical practice’, you must recognise and work within the limits of your competence and you must keep your knowledge and skills up to date. You must maintain and develop your knowledge and skills that are relevant to your role and practice in:

  • pharmacology and therapeutics
  • prescribing and managing medicines
  • any technology or processes you use to prescribe, for example via remote consultation.
9

You should make use of electronic and other systems that can improve the safety of your prescribing, for example by highlighting interactions and allergies and by ensuring consistency and compatibility of medicines prescribed, supplied and administered.

10

The Medicines and Healthcare products Regulatory Agency’s (MHRA) Drug Safety Update and Central Alerting System provide information and advice to support the safer use of medicines relevant to your practice and alert you to safety information about medicines you prescribe.

11

The National Institute for Health and Care Excellence (NICE) brings together evidence on the safe, effective and efficient use of medicines from a range of organisations in Evidence Search. It also publishes a range of products to help you improve the safety, as well as the clinical and cost effectiveness, of your prescribing. This includes Patient Decision Aids. The electronic Medicines Compendium contains Summaries of Product Characteristics and Patient Information Leaflets (PILs).

12

If you are unsure about interactions or other aspects of prescribing and managing medicines, you should seek advice from experienced colleagues, including pharmacists, prescribing advisers and clinical pharmacologists.

13

You must be familiar with the guidance in the British National Formulary (BNF) and British National Formulary for Children (BNFC), which contain essential information to help you prescribe, monitor, supply, and administer medicines.

14

You should follow the advice in the BNF on prescription writing and make sure your prescriptions and orders are clear, in accordance with the relevant statutory requirements. You should also make sure you include your name legibly.3  As well, you should consider including clinical indications4  on your prescriptions.

3

Electronic prescribing services can also be used. In England prescriptions can be sent electronically to a pharmacy; in Wales and Scotland, information is held in a barcode on a paper prescription. For more details see Get Started with EPS, Health and social Care information Centre; Prescriptions electronically, NHS Wales Informatics Service; Electronic Transfer of Prescriptions (ETP) , Scottish Government. Electronic prescribing services may be introduced in Northern Ireland in the future.

15

You should take account of the clinical guidelines published by:

  1. National Institute for Health and Care Excellence (England)
  2. Department for Health, Social Services and Public Safety (Northern Ireland)
  3. Healthcare Improvement Scotland (including the Scottish Medicines Consortium and Scottish Intercollegiate Guidelines Network) (Scotland)
  4. All-Wales Medicines Strategy Group (Wales)
  5. medical royal colleges and other authoritative sources of specialty specific clinical guidelines.
16

You should be careful about using medical devices for purposes for which they were not intended.

17

You should make sure that anyone you delegate responsibility for dispensing or administering medicines to is competent to do what you ask.5  Advice on training for dispensing support staff can be obtained from the General Pharmaceutical Council and Pharmaceutical Society of Northern Ireland (PSNI).

5

See explanatory guidance on Delegation and referral (2013). See also Supply and administration of Botox®, Vistabel®, Dysport® and other Injectable medicines in cosmetic procedures, Medicines and Healthcare products Regulatory Agency.

18

Where relevant, if you don’t wish to prescribe due to a conscientious objection, you should follow our explanatory guidance on ‘Personal beliefs and medical practice’.

19

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.6 

6

See Chapter 14 of the Human Medicines Regulations 2012 Number 1916 – SI 2012/1916 and ‘The Blue Guide: Advertising and Promotion of Medicines in the UK’ (MHRA, 3rd edition, 2nd revision, July 2019). The MHRA is an Agency of the Department of Health and Social Care with regulatory responsibility for medicines (for human use), blood and medical devices in the UK.