Keeping up to date and prescribing safely
Good medical practice says that you must recognise and work within the limits of your competence and that you must keep your knowledge and skills up to date. You must maintain and develop the knowledge and skills in pharmacology and therapeutics, as well as prescribing and medicines management, relevant to your role and prescribing practice.
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. The Medicines and Healthcare Products Regulatory Agency’s (MHRA) Drug Safety Update and the NHS Central Alert 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. NICE Evidence Search has extensive information on the safe, effective and efficient use of medicines. The National Prescribing Centre (now part of the National Institute for Health and Clinical Excellence (NICE)) publishes a range of materials to help you improve the safety and clinical and cost effectiveness of your prescribing. The electronic Medicines Compendium lists Summaries of Product Characteristics and Patient Information Leaflets.
If you are unsure about interactions or other aspects of prescribing and medicines management you should seek advice from experienced colleagues, including pharmacists, prescribing advisers and clinical pharmacologists.
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.
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 and include your name legibly.2 You should also consider including clinical indications3 on your prescriptions.
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
You should take account of the clinical guidelines published by the:
- NICE (England)
- Scottish Medicines Consortium and Health Improvement Scotland (including the Scottish Intercollegiate Guidelines Network) (Scotland)
- Department for Health, Social Services and Public Safety (Northern Ireland)
- All-Wales Medicines Strategy Group (Wales)
- medical royal colleges and other authoritative sources of specialty specific clinical guidelines.
You should make sure that anyone to whom you delegate responsibility for dispensing medicines in your own practice is competent to do what you ask of them. Advice on training for dispensing support staff can be obtained from the General Pharmaceutical Council.
You should make sure that anyone to whom you delegate responsibility for administering medicines is competent to do what you ask of them.4
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.