Prescription requirements Flashcards
Here is a general summary of the prescription requirements that cover the legal requirements and other information needed for the prescription to be complete including good practice recommendations.
Firstly, the legal requirements for a prescription are provided below. They must be fulfilled for the prescription to be legal and apply to general prescriptions.
- State the name of the patient
- State the address of the patient
- State the age of the patient if under 12 years of age
- The prescription should be signed in ink by the prescriber
- The prescription should be written clearly or printed in ink or otherwise be indelible. - - A prescriber can issue an NHS prescription using carbon paper or a similar material, but the signature must be in ink.
- The prescription should indicate the type of prescriber that is signing the prescription e.g. doctor, dentist, community practitioner nurse prescriber
- State the appropriate date (https://www.legislation.gov.uk/uksi/2012/1916/regulation/217). A prescription is valid for six months from the appropriate date (except for drugs belonging to schedules 2-4).
- State the address of the prescriber
- With regards to electronic prescriptions that are sent electronically, an advanced electronic signature can be accepted. The Human Medicines Regulations 2012 (Regulations 217 and 219) sets out that the signature should be uniquely linked to the person giving the prescription, can identify the person who wrote the prescription, be created using the means that the person can maintain under its sole control and linked to the data which it relates in such a manner that any subsequent change of data is detectable. In addition to this, the prescription is sent via the electronic prescription service to the person who will dispense the prescription.
Secondly, for the prescription to be complete (these are not legal requirements) the prescription should state the following:
- Name of medicine e.g. generic name, brand name
- Dosage form e.g. tablets, capsules, m/r tablets, liquid
- Route of administration e.g. oral, subcutaneous
- Strength of medicine e.g. 50mg, 250mg/5ml
- The dose and frequency to be taken/given
- Quantity prescribed or the number of days’ treatment to dispense
Finally, it is good practice to also include the following on the prescription:
- Age of the patient
- Date of birth of the patient
- Weight of the patient (including this information allows the pharmacist to determine whether the dose is safe and appropriate for the patient’s weight)
- Patient’s NHS number
- Clinical indication for each medicine
Prescribing rights of doctors
A doctor can prescribe:
- licensed medicines
- unlicensed medicines
- off-label or off-license medicines
appliances, dressings and chemical reagents - controlled drugs in Schedules 2-5 (only doctors who possess a license issued by the Home Office are authorized to prescribe diamorphine, dipipanone and cocaine for the treatment of addiction)
Doctors are registered with the General Medical Council. To find out if a doctor is registered, search the General Medical Council’s register.
Prescribing rights of dentists
A dentist can prescribe:
- licensed medicines
- unlicensed medicines
- off-label or off-license medicines
appliances - controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction)
A dentist can prescribe anything (e.g. medicines, appliances) listed in the British National Formulary (BNF) and British National Formulary for Children (BNFC) on a private prescription, but they must only prescribe to address the specific dental requirements of their patients and should only prescribe within their competence.1,2
With regards to NHS prescriptions, dentists can only prescribe certain medicines and appliances that are listed in the Drug Tariff for England, Wales, Scotland and Northern Ireland, as well as in the List of Dental Preparations in the British National Formulary.
A dentist is registered with the General Dental Council. To find out if a dentist is registered, search the General Dental Council’s register.
https://www.sps.nhs.uk/articles/when-and-how-can-dentists-supply-medicines/
Prescribing rights of pharmacist independent prescribers
A pharmacist independent prescriber can prescribe the following, but they must work within their level of professional competence and expertise:
- licensed medicines
- controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction)
- unlicensed medicines
- off-label or off-license medicines
appliances, dressings and chemical reagents
Pharmacist independent prescribers can write private prescriptions (in addition to NHS prescriptions).
To find out if a pharmacist is registered and also holds the independent prescriber’s qualification to be able to prescribe, go to the General Pharmaceutical Council’s register.
Prescribing rights of optometrist independent prescribers
An optometrist independent prescriber can prescribe:
- Any licensed medicine (except for controlled drugs or medicines for parenteral administration) for conditions affecting the eye, and the tissues surrounding the eye, within their recognised area of expertise and competence.
They can also prescribe:
- off-label or off-license medicines; however, the General Optical Council discourages optometrists from prescribing off-label or off-license medicines.
- appliances (only allowed to prescribe these to treat conditions that are specific to their area of professional practice).
Optometrist independent prescribers cannot prescribe unlicensed medicines.
Optometrist independent prescribers can write private prescriptions (in addition to NHS prescriptions).
An optometrist is registered with the General Optical Council. To confirm an optometrist’s registration and independent prescriber qualification, search the General Optical Council’s register.
What types of medicines can doctors prescribe?
Licensed medicines, unlicensed medicines, off-label or off-license medicines, appliances, dressings, chemical reagents, and controlled drugs in Schedules 2-5.
Which controlled drugs require a Home Office license for doctors to prescribe for addiction treatment?
Diamorphine, dipipanone, and cocaine.
Which organization registers doctors in the UK?
The General Medical Council (GMC).
What controlled drugs can dentists prescribe?
Controlled drugs in Schedules 2-5, excluding diamorphine, dipipanone, and cocaine for the treatment of addiction.
What limitations exist for dentists prescribing on NHS prescriptions?
They can only prescribe medicines and appliances listed in the Drug Tariff and List of Dental Preparations in the British National Formulary (BNF).
Which organization registers dentists in the UK?
The General Dental Council (GDC).
What types of medicines can pharmacist independent prescribers prescribe?
Licensed medicines, controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone, and cocaine for addiction), unlicensed medicines, off-label medicines, appliances, dressings, and chemical reagents.
Can pharmacist independent prescribers write private prescriptions?
Yes, they can write both private and NHS prescriptions.
Which organization registers pharmacists and verifies prescribing qualifications?
The General Pharmaceutical Council (GPhC).
What medicines can optometrist independent prescribers prescribe?
Any licensed medicine, except for controlled drugs or medicines for parenteral administration.
What is a restriction placed on optometrist independent prescribers?
They cannot prescribe unlicensed medicines.
Which organization registers optometrists and verifies their prescribing qualifications?
The General Optical Council (GOC).
What can a community practitioner nurse prescriber prescribe?
Medicines listed in the Nurse Prescribers Formulary (NPF) for Community Practitioners.
What can a nurse independent prescriber prescribe?
Medicines/products listed in the BNF, controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone, and cocaine for addiction), unlicensed medicines, and off-label medicines.
Which organization registers nurses and verifies prescribing qualifications?
The Nursing and Midwifery Council (NMC).
What types of medicines can physiotherapist independent prescribers prescribe?
Any licensed medicines from the BNF, off-label medicines, appliances, and dressings.
Name three controlled drugs that physiotherapist independent prescribers can prescribe.
Temazepam (oral), morphine (oral/injectable), and fentanyl (transdermal).
Can physiotherapist independent prescribers prescribe unlicensed medicines?
No, they cannot prescribe unlicensed medicines.
Which organization registers physiotherapist independent prescribers?
The Health and Care Professions Council (HCPC).
What types of medicines can chiropodist/podiatrist independent prescribers prescribe?
Any licensed medicines from the BNF, controlled drugs for organic disease or injury, appliances, and dressings.
Name two controlled drugs that chiropodist/podiatrist independent prescribers can prescribe.
Diazepam (oral), dihydrocodeine (oral).
Can chiropodist/podiatrist independent prescribers prescribe unlicensed medicines?
No, they cannot prescribe unlicensed medicines.
Which organization registers chiropodist/podiatrist independent prescribers?
The Health and Care Professions Council (HCPC).
What types of medicines can paramedic independent prescribers prescribe?
Any licensed medicine, off-label medicines, controlled drugs for organic disease or injury, appliances, dressings, and chemical reagents.
Name three controlled drugs that paramedic independent prescribers can prescribe.
Morphine sulfate (oral/injectable), lorazepam (injectable), midazolam (oromucosal/injectable).
Can paramedic independent prescribers prescribe unlicensed medicines?
No, they cannot prescribe unlicensed medicines.
Which organization registers paramedic independent prescribers?
The Health and Care Professions Council (HCPC).
What types of medicines can therapeutic radiographer independent prescribers prescribe?
Most licensed medicines, off-label medicines, and controlled drugs for organic disease or injury.
Name three controlled drugs that therapeutic radiographer independent prescribers can prescribe.
Tramadol (oral), morphine (oral/injectable), oxycodone (oral).
Can therapeutic radiographer independent prescribers prescribe unlicensed medicines?
No, they cannot prescribe unlicensed medicines.
Which organization registers therapeutic radiographer independent prescribers?
The Health and Care Professions Council (HCPC).
What can supplementary prescribers prescribe?
Any medicine, including unlicensed, off-label medicines, and controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone, and cocaine for addiction).
What is the key condition for supplementary prescribing?
The medicine must be specified in a clinical management plan (CMP) and fall within the prescriber’s clinical competence.
Name four healthcare professionals who can act as supplementary prescribers (CHECK https://www.resourcepharm.com/pharmacy-law-and-ethics/prescribing-rights-independent-and-supplementary-prescribers.html)
Pharmacists, nurses, optometrists, paramedics (and others such as midwives, physiotherapists, radiographers, and chiropodists/podiatrists).
