This ethical hub topic shows ways in which our ethical guidance can be applied in this area of care and signposts to relevant resources. It does not set new professional standards and is not intended to replace the formal guidance.
Remote consultations (over the phone, via video link or online) have increased. So when is it safe to prescribe without meeting a patient face to face?
The flow chart below may help doctors apply our ethical guidance to manage patient safety risks and decide when it’s usually safe to treat patients remotely. For the latest guidance on remote consultations in a pandemic see our COVID-19 FAQs.
Is a remote consultation appropriate?
Remember these three principles
Our standards of good practice apply to both face to face and remote consultations.
If you can’t meet our standards for safe prescribing in a remote consultation, you should change to face to face.
You should agree with the patient the most suitable method of consultation within the resources available.
"We welcome innovations in medical practice that enable good care for patients, and support the use of remote prescribing that follows our clear prescribing guidance used in consultation with a patient in person or online."
Charlie Massey - Chief Executive and Registrar of the General Medical Council
Good practice – key issues
Ensure that the medium you are using does not affect your ability to follow the law and our guidance. Consent and continuity of care are key issues to remember when you are advising or prescribing treatment for a patient via remote consultation.
- Give patients information about all the options available to them (including the option not treat) in a way they can understand.
- Tailor the information you give, and the way you give it, to patients’ individual needs, and check that they’ve understood it.
- If you’re not sure a patient has all the information they want and need, or that they’ve understood it, consider whether it is safe to provide treatment and whether you have valid consent
- You must ensure you can assess a patient's capacity. If a patient lacks capacity to make a decision, consider whether remote consultation is appropriate, including whether you can meet the requirements of mental capacity law.
Continuity of care
- If you’re not the patient’s GP, ask the patient for consent to get information and a history from their GP and to send details of any treatment you’ve arranged.
- If the patient refuses, explore their reasons and explain the potential impact of their decision on their continuing care.
- If the patient continues to refuse, consider whether it is safe to provide treatment.
- Make record of your decision and be prepared to explain and justify it if asked to do so.
- Follow our guidance on consent and good practice in prescribing
- Work within your competence
- Check you have adequate indemnity cover for your remote consultation activities
- Discuss this element of your practice in your appraisals.
High level principles
Good practice in prescribing and managing medicines and devices
Paragraphs 21 - 26 - Does the mode of consultation meet the individual needs of the patient and support safe prescribing?
Paragraphs 27 – 33 - Do you have enough information about the patient to prescribe a treatment that meets their need?
Paragraphs 34 – 38 - Establishing a dialogue
Paragraphs 59 – 66 - Controlled drugs and other medicines where additional safeguards are needed
Paragraph 70 - Prescribing for patients in a care or nursing home or hospice
Paragraphs 71 – 73 Prescribing for patients based overseas