Good practice in proposing, prescribing, providing and managing medicines and devices

About this guidance

1

In ‘Good medical practice’ (2024)1  we say:

1

‘Good medical practice’ (2024) London, General Medical Council

2. You must recognise and work within the limits of your competence.

4. You must follow the law, our guidance on professional standards, and other regulations relevant to your work.

7. In providing clinical care you must: 

d. propose, provide or prescribe drugs or treatment (including repeat prescriptions) only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment will meet their needs

e. propose, provide or prescribe effective treatment based on the best available evidence

14. You must make good use of the resources available to you, and provide the best service possible, taking account of your responsibilities to patients and the wider population.

39. You should ask patients about any other care or treatment they are receiving – including over-the-counter medications – and check that any care or treatment you propose, provide or prescribe is compatible.

69. You must make sure that formal records of your work (including patients’ records) are clear, accurate, contemporaneous  and legible. 

70. You should take a proportionate approach to the level of detail but patients’ records should usually include:

a. relevant clinical findings

b. drugs, investigations or treatments proposed, provided or prescribed 

c. the information shared with patients 

d. concerns or preferences expressed by the patient that might be relevant to their ongoing care, and whether these were addressed 

e. information about any reasonable adjustments and communication support preferences 

f. decisions made, actions agreed (including decisions to take no action) and when/whether decisions should be reviewed

g. who is creating the record and when.

2

This guidance, which forms part of the professional standards, gives more detailed advice on how to comply with these principles when proposing, prescribing, or providing and managing medicines and medical devices. The guidance applies to all forms of activity around prescribing, in whatever setting your interaction takes place, including remote consultations.

What does this guidance cover?

3

This guidance covers a range of related activities that surround and support prescribing as well as prescribing itself. Of our registrants, only doctors have the authority to sign prescriptions, but the guidance covers a broader range of related activities, including:

  1. Supplying prescription only medicines
  2. proposing prescription-only medicines for an authorised prescriber to review and sign (see paras 4 and 75-79)
  3. providing prescription-only medicines to patients after these have been reviewed and signed by an authorised prescriber
  4. recommending or prescribing other medicines, devices, dressings and activities, such as exercise
  5. advising patients on the purchase of over-the-counter medicines and other remedies
  6. giving written information (information prescriptions) or advice to patients
4

All the professionals we regulate are expected to follow this guidance to the extent that it is relevant to their practice.2  Whatever element of prescribing activity you are involved in, you are responsible for your decisions and actions, and the steps you take to ensure that prescriptions are appropriate, necessary and safe (see paras 75-79 below on shared care).

2

PAs and AAs cannot prescribe prescription-only medicines, but they are involved in proposing medications or devices for an authorised prescriber to review and sign. The Department of Health and Social Care has confirmed that once PAs and AAs are regulated roles, individuals employed in these capacities cannot lawfully prescribe using prescribing rights from another regulated role. Prescribing rights are specific to the regulated profession in which they were granted (conferred upon individuals after undergoing the necessary training) and aren’t transferable. For example, if you gained prescribing rights as a nurse or doctor, you cannot use them while working as a PA or AA. From 13 December 2024, healthcare professionals employed in designated PA or AA roles should not prescribe medicines, even if they hold prescribing rights from a previous profession or have previously been authorised to prescribe by their employer.

5

Prescribing happens in a range of contexts, including face to face and remotely using telephone, online and video-link or other technological platforms. If you can’t meet the standards set out in this guidance through the mode of consultation you are using, you should offer an alternative if possible, or signpost to other services. If you think that systems, policies or procedures are, or may be, placing patients at risk of harm, you must follow the guidance in ‘Raising and acting on concerns about patient safety’3 

3

‘Raising and acting on concerns about patient safety’ (2012) London, General Medical Council

6

The professional standards describe good practice, and not every departure from them will be considered serious. You must use your professional judgement to apply the standards to your day-to-day practice. If you do this, act in good faith and in the interests of patients, you will be able to explain and justify your decisions and actions. We say more about professional judgement, and how the professional standards relate to our fitness to practise processes, appraisal and revalidation, at the beginning of Good medical practice.