The General Medical Council (GMC) has updated its prescribing guidance for doctors. Good Practice in Prescribing and Managing Medicines and Devices broadens the current advice to include medical devices. The guidance widens the definition of prescribing to include:
- Advising patients on the purchase of over-the-counter medicines and other remedies.
- Providing written information (described as information prescriptions) and advice given.
The guidance also covers:
- Unlicensed medicines – the guidance refers to the fact that there may be circumstances when it is necessary to prescribe an unlicensed medicine and provides guidance as to what steps to take in such circumstances.
- Prescribing for self and family – the guidance reiterates the guidance in Good Medical Practice in stating that wherever possible doctors should not prescribe for themselves or anyone with whom they have a close personal relationship. The guidance places doctors under an additional obligation to make a clear record (which should include your relationship with the patient and the reason why it was necessary to prescribe) and to inform their own or the patient’s GP unless (in the case of prescribing for somebody close to them) they object.
- Cosmetic treatment – you must not prescribe drugs, such as Botox or other similar injectable cosmetics, by phone, email, video-link or fax.
- Adverse incidents – you must report any adverse incidents involving drugs, medical devices – such as x-ray and other imaging equipment – pacemakers, artificial joints and anaesthetic equipment.
The new guidance came into effect on 25 February 2013.
The guidance refers to the fact that there may be circumstances when it is necessary to prescribe an unlicensed medicine and provides guidance as to what steps to take in such circumstances
From practice to planet
A GP has become a YouTube sensation, clocking thousands of hits with his weekly health videos. Dr Ricky Gondhia, a salaried GP, at Crayford Town Surgery in London, fronts the One Click Clinic. His most popular video-sharing advice on cold and flu has clocked up 12,114 hits since it was uploaded in December.
Top ten calls from GPs in 2012
- General advice
- Issues around confidentiality
- Disclosure of records
- Writing reports
- Clinical judgment
- Adverse incident reports
NICE guidance watch
NICE guidance relevant to primary care: April – June 2013 (provisional publication dates)
- Conduct disorders in children and young people
- Asthma (severe, persistent, patients aged 6+, adults) – omalizumab
- Care of people with dementia
- Health and wellbeing of looked-after children
- Management of venous thromboembolic diseases
- Social anxiety disorder
- Feverish illness in children
Public health guidance
- Tobacco – harm reduction
- Physical activity – brief advice in primary care (partial update of Ph2)
- Diabetes (type 2) – dapagliflozin
- Familial breast cancer (update)
- Stroke rehabilitation
- Hepatitis B
- Idiopathic pulmonary fibrosis
- Ulcerative colitis
Public health guidance
- BMI and waist circumference – black, Asian and minority ethnic groups
- Overactive bladder – mirabegron
- Gout (tophaceous, severe debilitating, chronic) – pegloticase
- Rheumatoid arthritis
Note: These anticipated publication dates are subject to change. To keep up-to-date visit www.nice.org.uk/GP or follow NICE on Twitter (@NICEComms)
MPS policy update – online records
Allowing patients to view their medical records online is reminiscent of opening a ‘Pandora’s Box’, whereby patient confidentiality could be compromised, says MPS.
MPS is concerned that when access is granted, it could have unintended and severe consequences, such as sensitive information being accessed by a patient’s family members.
An MPS survey revealed that this is a view shared by both the public and doctors:
- 80% of the public would be concerned for the security of their medical records
- 86% of MPS members would be concerned for the security of patients’ medical records if they become accessible online.
When access is granted, it could have unintended and severe consequences, such as sensitive information being accessed by a patient’s family members
MPS wants a firm commitment from the government that the information strategy will not compromise patient confidentiality – because once the contents of ‘Pandora’s Box’ have been released into the wrong hands, the damage cannot be undone. MPS will share these findings at a Parliamentary Reception on 30 April 2013.
The MHRA has opened new Twitter channels, including one for medicines and devices safety updates.
- @MHRAmedicines lists medicines information and safety alerts
- @MHRAdevices lists devices information and safety alerts
- @MHRAherbals lists information on the safe use of herbal remedies
For more information visit www.mhra.gov.uk/Stayconnected/Twitter/index.htm.
News in brief
GPs refer more than 80% of suspected cancer cases within two consultations, according to a report in the British Journal of Cancer, which used data from the English National Audit of Cancer diagnosis in Primary Care 2009-2010. The data covered 13,035 people with any of 18 different cancers.
The researchers found:
- 58% of patients were referred after the first consultation
- 25% were referred after two
- 5% were referred after five or more
- Patients with multiple myeloma and lung cancer had high proportions of three or more pre-referral consultations (46% and 33% respectively)
- Breast cancer and melanoma patients were generally referred sooner
Source: British Journal of Cancer
GPs refer more than 80% of suspected cancer cases within two consultations
IBM has unveiled a super-computer, capable of sorting through millions of pages of medical research and 600,000 pieces of medical evidence in order to diagnose cancer symptoms. Known as ‘Watson’, the mighty machine speeds up the way data is analysed to make the best diagnosis and find the optimal treatment.
Watch this space
An increasing number of GPs are requiring pastoral support, LMC leaders have claimed. Figures from one LMC show a four-fold increase in the numbers of GPs presenting to pastoral care services in the first half of 2012 compared to the same period in 2011, and a doubling of the numbers overall.
An LMC-run survey of 2,700 GPs across the South West found half were considering quitting general practice and two thirds believed their practice would struggle to remain viable due to the government’s planned contract changes.
A survey found half [of GPs are] considering quitting general practice and two thirds believed their practice would struggle to remain viable