Dr Stephanie Bowm, MPS Director of Policy and Communications, provides a reminder of the importance of following GMC guidance when prescribing medication.
Approximately one in five clinical negligence claims made against a doctor are in relation to medication errors. Adverse events and inappropriate prescribing are estimated to cost more than £750 million per year, highlighting the importance of doctors being well-informed on the relevant medical law and ethics.
The term "prescribing" can be used in relation to many related activities, including the supply of prescription only medicines, the prescribing of medicines, devices and dressings on the NHS and advice to patients on the purchase of over the counter medicines and other remedies. It may also describe "information prescriptions", which are written information provided for patients.
According to the GMC's Good Medical Practice, drugs or treatment, including repeat prescriptions, should only be prescribed by a doctor with adequate knowledge of the patient's health, and who is therefore satisfied that the prescription serves the patient's needs. The GMC has also issued explanatory guidance, Good Practice in Prescribing and Managing Medicines and Devices which all doctors should familiarise themselves with. And of course, the doctor must ensure that their own interests are not allowed to affect the way they prescribe for patients.
Doctors should also be familiar with the British National Formulary's current guidance concerning the use, side effects and contraindications of the medicines that they intend to prescribe. There may also be specific prescribing policies and guidance from their local commissioning body that they should pay close attention to. Be aware that in the event of something going wrong, the person who is held accountable will usually be the person who signed the prescription.
Other important aspects of the medical law and ethics relationship to safe
prescribing include checking that the correct dosage of the medicine – including the strength, route and frequency – is being prescribed, which is especially important when prescribing for children. Contraindications must also be checked, including allergies, interactions with other treatments and underlying medical conditions.
"The doctor must fully inform the patient about why the proposed medication is being recommended and the expectations of treatment and side effects of medication"
Another aspect of law and ethics applied to prescribing is the principle of informed consent. The doctor must fully inform the patient about why the proposed medication is being recommended and the expectations of treatment and side effects of medication. Warning the patient of any sedative side effects may also be important if they operate machinery or drive.
Appropriate arrangements for monitor
Special care should be taken when prescribing controlled drugs, as different prescribing criteria may apply. Doctors should refer to the BNF for more advice on prescribing or writing a prescription.ing and follow-up should also be agreed with the patient, and a clear record made in the patient's notes. Despite the now common use of computer-generated prescriptions, doctors may still hand-write prescriptions, in which case, important safety considerations include not abbreviating drug names or using decimal places if they are not necessary, while also clearly documenting the drug, dose, strength, route and frequency.