Prescribing Standards

Question 1

True or False: Dispensing a medicinal product means that you are confirming the diagnosis of the patient.

Answer 1

True

Question 2

What are the responsibilities of a Pharmacist Independent Prescriber (PIP)?

Answer 2

• Clinical assessment
• Diagnosis
• Management planning
• Safe and appropriate prescribing

Question 3

What can PIPs prescribe?

Answer 3

• Licensed medicines
• Off label medicines
• Unlicensed medicines
• Schedule 2-5 (but not for addiction treatment)

Question 4

What can’t a PIP prescribe?

Answer 4

Diamorphine, dipipanone or cocaine for the purpose of treating addiciton.

Question 5

What 2 things need to be considered when prescribing and deprescribing?

Answer 5

• Patient consent
• Using Professional judgement

Question 6

What needs to be taken into consideration when communicating effectively with a patient?

Answer 6

• Understanding patient needs
• Patient capacity
• Shared-decision making
• Risks and benefits

Question 7

What can we use to get all the necessary patient information?

Answer 7

Medical records.

Question 8

When is it appropriate to prescribe unlicensed or off-label medicines?

Answer 8

When their is sufficient evidence of safety, efficacy and appropriateness.

Question 9

What must PIPs do after any prescribing changes?

Answer 9

Communicate and document it in the patient’s record.

Question 10

What must a PIP do if they decide not to prescribe?

Answer 10

Justify reason why.

Question 11

What is the Yellow Card Scheme used for?

Answer 11

For reporting adverse drug reactions (ADRs)

Question 12

What is safety netting in prescribing?

Answer 12

Ensuring patients know what to do if symptoms change or worsen.

Question 13

Can PIPs prescribe in all clinical areas?

Answer 13

No, they must only prescribe within their scope of practice and competence.

Question 14

What must PIPs do to ensure they provide safe care?

Answer 14

• Keep their knowledge and skills up-to-date
• Only prescribe within their competence

Question 15

What must PIPs undertake if returning to practice after a break?

Answer 15

CPPE return to prescribing course.

Question 16

What must PIPs undertake when prescribing in a different clinical area?

Answer 16

RPS professional guidance: expanding scope of practice

Question 17

What does the ‘scope of practice’ mean?

Answer 17

Prescribing activities a healthcare professional carries out for which they have had appropriate training, knowledge and experience for.

Question 18

Why is working with other healthcare professionals essential in prescribing?

Answer 18

Ensures safe and effective care of the patient.

Question 19

What should PIPs maintain when sharing information?

Answer 19

• Confidentiality
• Patient consent

Question 20

When is it appropriate to share prescribing information without consent?

Answer 20

• It is in the patient’s best interests
• Patient lacks capacity

Question 21

What must be done before sharing prescribing information with other healthcare professionals?

Answer 21

• Patient consent
• Patient is informed of what will be shared

Question 22

Are PIPs accountable when continuing treatment started by another healthcare professional?

Answer 22

Yes, they are fully responsible for ensuring the medicine is appropriate.

Question 23

What is a DPP?

Answer 23

A Designated Prescribing Practitioner
-> Supervise trainee prescribers and ensure safe practice

Question 24

Who are PIPs not allowed to prescribe for?

Answer 24

• Themselves
• Family members
• Friends
• Colleagues

Question 25

What are the exceptional circumstances under when a PIP can prescribe to people they are not allowed to prescribe for?

Answer 25

- When there is no other prescriber available - When delay would put the person's life at risk - To relieve uncontrollable pain or distress

Question 26

What must be documented if a PIP prescribes for a family member?

Answer 26

- Relationship - Reason for prescribing - Justification

Question 27

Should PIPs prescribe AND supply the medicine?

Answer 27

Another trained colleague should complete the clinical and accuracy check. -> protect patient safety and minimise risk

Question 28

Can PIPs prescribe botulinum toxin for cosmetic use?

Answer 28

Yes but only with proper training and after a face-to-face consultation.

Question 29

True or False: If administration of a botulinum toxin is delegated, the responsibility moves to the person administering it.

Answer 29

False, you are still responsible for the ongoing oversight of the person and the safe outcome.

Question 30

Give some examples of patients where there may be patient safety at risk.

Answer 30

- Vulnerable patients - Patients at risk of an addiction - Patients who may not have capacity

Question 31

Which medicines need extra safeguards?

Answer 31

- High-risk meds - CDs - Narrow Therapeutic Index drugs - Antimicrobials - Sodium Valproate

Question 32

Why is it important to raise concerns in pharmacy practice?

Answer 32

- Protect patients - Promote safety

Question 33

What does the GPhC say about raising concerns?

Answer 33

Pharmacists must speak up when they have concerns or when things go wrong.

Question 34

What should you do if another prescribers actions seem unsafe?

Answer 34

- Question the decision - Raise the concern if the patient's health is at risk - Escalate to the appropriate regulator

Question 35

What are the risks of raising concerns anonymously?

Answer 35

- Others may still find out who it was - Harder to ask follow-up questions - Harder to get protection from the UK Public Interest Disclosure Act - Focus may shift to who made the complaint rather than the actual issue

Question 36

Who are you encouraged to approach first when wanting to raise a concern?

Answer 36

Your employer.