You can find the latest version of this guidance on  
              our website at www.gmc-uk.org/guidance
               THIS GUIDANCE COMES INTO EFFECT  
               ON 5 APRIL 2021
              Good practice in  
              prescribing and managing 
              medicines and devices
              You are responsible for the prescriptions that you         This guidance comes into effect on 5 April 2021.
              sign. You must only prescribe medicine when you 
              have adequate knowledge of your patient’s health. 
              And you must be satisfied that the medicine serves 
              your patient’s need.                                       Download the guidance
              Following this guidance will help make sure that you       You can download this guidance in English or Welsh.
              practise safe prescribing. It reminds you that, where      n    Prescribing and managing medicines and devices 
              possible, you must avoid prescribing for yourself or           (English)
              those close to you. 
                                                                         n    Presgripsiynu a rheoli meddyginiaethau a dyfeisiau 
              This guidance covers what you need to consider                 (Cymraeg)
              when prescribing unlicensed medicines, repeat 
              prescribing and when you share responsibility for 
              your patient with a colleague. It also gives important 
              advice on how to work safely when you’re not the 
              patient’s regular prescriber or when you are providing 
              care for patients remotely, including those who are 
              based overseas.
              This guidance applies equally to all prescribing, in 
              whatever setting your interaction with a patient takes 
              place, including remote consultations. If you can’t 
              meet the standards, it may be appropriate to offer an 
              alternative mode for the consultation to ensure safe 
              care that meets our standards.
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                                             Good practice in prescribing and managing medicines and devices
                                             About this guidance 
                                                                                                                                                                                       1
                                                     1              In ‘Good medical practice’ (2013)  we say:                                                                                                                                                     n   18   You must make good use of the  
                                                                    n  12   You must keep up to date with, and                                                                                                                                                                            resources available to you.
                                                                                           follow, the law, our guidance and other                                                                                                                                 n   19  Documents you make to formally record 
                                                                                           regulations relevant to your work.                                                                                                                                                           your work, including clinical records, 
                                                                    n   14   You must recognise and work within the                                                                                                                                                                     must be clear, accurate and legible. You 
                                                                                            limits of your competence.                                                                                                                                                                  should make records at the same time 
                                                                                                                                                                                                                                                                                        as the events you are recording or as 
                                                                    n   16  In providing clinical care you must:                                                                                                                                                                        soon as possible afterwards.
                                                       a   prescribe medicine or treatment,                                                                                                                                                                        n   21 Clinical records should include:
                                                                                          including repeat prescriptions, only 
                                                                                          when you have adequate knowledge of                                                                                                                        a  relevant clinical findings
                                                                                          the patient’s health, and are satisfied                                                                                                                    b the decisions made and actions agreed,  
                                                                                          that the medicine or treatment serve                                                                                                                                                          and who is making the decisions and  
                                                                                          the patient’s needs                                                                                                                                                                           agreeing the actions
                                                       b provide effective treatments based on                                                                                                                                                       c  the information given to patients
                                                                                          the best available evidence
                                                       f   check that the care or treatment you                                                                                                                                                      d any drugs prescribed or other  
                                                                                          provide for each patient is compatible                                                                                                                                                        investigation or treatment
                                                                                          with any other treatments the patient                                                                                                                      e who is making the record and when.
                                                                                          is receiving, including where possible  
                                                                                          self-prescribed over-the-counter  
                                                                      medications.
                                             2               This guidance gives more detailed advice on                                                                                                                                                            a  supplying prescription-only medicines 
                                                             how to comply with these principles when                                                                                                                                                               b   prescribing medicines, devices, dressings and 
                                                             prescribing and managing medicines and medical                                                                                                                                                                    activities, such as exercise
                                                             devices. The guidance applies to all prescribing 
                                                             in whatever setting your interaction takes place,                                                                                                                                                      c  advising                              patients on the purchase of over the 
                                                             including remote consultations.                                                                                                                                                                                   counter medicines and other remedies. 
                                             3               You are responsible for the prescriptions you                                                                                                                                          5               It may also be used to describe any written 
                                                             sign. You are also accountable for your decisions                                                                                                                                                      information (information prescriptions) or advice 
                                                             and actions when supplying or administering                                                                                                                                                            you give to patients. While some of this guidance 
                                                             medicines and devices, and when authorising or                                                                                                                                                         is particularly relevant to prescription-only 
                                                             instructing others to do so.                                                                                                                                                                           medicines, you should follow it in relation to 
                                                                                                                                                                                                                                                                    the other activities you undertake, so far as it is 
                                             4               ‘Prescribing’ is used to describe many related                                                                                                                                                         relevant and applicable. 
                                                             activities, including: 
                                                                                                                                                                                                                                                                                                                                                                                                                                    02
                         Good practice in prescribing and managing medicines and devices
                         6        Prescribing happens in a range of contexts,                                                         10  The Medicines and Healthcare products 
                                  including face to face and remotely using                                                                    Regulatory Agency’s (MHRA) Drug Safety Update 
                                  telephone, online and video-link or other                                                                    and Central Alerting System provide information 
                                  technological platforms. If you can’t meet the                                                               and advice to support the safer use of medicines 
                                  standards set out in this guidance through the                                                               relevant to your practice and alert you to safety 
                                  mode of consultation you are using, you should                                                               information about medicines you prescribe. 
                                  offer an alternative if possible, or signpost to 
                                  other services. If you think that systems,                                                          11  The National Institute for Health and Care 
                                  policies or procedures are, or may be, placing                                                               Excellence (NICE) brings together evidence on 
                                  patients at risk of harm, you must follow the                                                                the safe, effective and efficient use of medicines 
                                  guidance in ‘Raising and acting on concerns                                                                  from a range of organisations in Evidence Search. 
                                                                          2                                                                    It also publishes a range of products to help you 
                                  about patient safety’.  
                                                                                                                                               improve the safety, as well as the clinical and cost 
                         7        You must be prepared to explain and justify                                                                  effectiveness, of your prescribing. This includes 
                                  your decisions and actions when prescribing,                                                                 Patient Decision Aids. The electronic Medicines 
                                  administering and managing medicines and                                                                     Compendium contains Summaries of Product 
                                  devices. Only serious or persistent failure to                                                               Characteristics and Patient Information  
                                  follow our guidance that poses a risk to patient                                                             Leaflets (PILs).
                                  safety or public trust in doctors will put your 
                                  registration at risk.                                                                               12  If you are unsure about interactions or other 
                                                                                                                                               aspects of prescribing and managing medicines, 
                                                                                                                                               you should seek advice from experienced 
                         Keeping up to date and prescribing safely                                                                             colleagues, including pharmacists, prescribing 
                                                                                                                                               advisers and clinical pharmacologists. 
                         8        As outlined in ‘Good medical practice’, you must 
                                  recognise and work within the limits of your                                                        13   You must be familiar with the guidance in the 
                                  competence and you must keep your knowledge                                                                  British National Formulary (BNF) and British 
                                  and skills up to date. You must maintain and                                                                 National Formulary for Children (BNFC), 
                                  develop your knowledge and skills that are                                                                   which contain essential information to help 
                                  relevant to your role and practice in:                                                                       you prescribe, monitor, supply, and administer 
                                                                                                                                               medicines.
                                  n   pharmacology and therapeutics
                                  n   prescribing and managing medicines                                                              14   You should follow the advice in the BNF 
                                  n   an     y technology or processes you use                                                                 on prescription writing and make sure your 
                                        to prescribe, for example via remote                                                                   prescriptions and orders are clear, in accordance 
                                        consultation.                                                                                          with the relevant statutory requirements. You 
                                                                                                                                               should also make sure you include your name 
                                                                                                                                                            3
                         9        You should make use of electronic and other                                                                  legibly.  As well, you should consider including 
                                                                                                                                                                                 4
                                  systems that can improve the safety of your                                                                  clinical indications  on your prescriptions.
                                  prescribing, for example by highlighting 
                                  interactions and allergies and by ensuring 
                                  consistency and compatibility of medicines 
                                  prescribed, supplied and administered. 
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                                             Good practice in prescribing and managing medicines and devices
                                             15  You should take account of the clinical guidelines                                                                                                                                                 Deciding if it is safe to prescribe 
                                                             published by:
                                                             a  National Institute for Health and Care                                                                                                                                              20   You should only prescribe medicines if you have 
                                                                        Excellence (England)                                                                                                                                                                        adequate knowledge of the patient’s health and 
                                                             b   Department for Health, Social Services and                                                                                                                                                         you are satisfied that the medicines serve the 
                                                                        Public Safety (Northern Ireland)                                                                                                                                                            patient’s needs. You must consider:
                                                             c   Healthcare Improvement Scotland (including                                                                                                                                                         a   the suitability of the mode of consultation 
                                                                        the Scottish Medicines Consortium and                                                                                                                                                                  you are using, for example face to face or 
                                                                        Scottish Intercollegiate Guidelines Network)                                                                                                                                                           remote, taking account of any need for 
                                                                        (Scotland)                                                                                                                                                                                             physical examination or other assessments 
                                                             d  All-Wales Medicines Strategy Group (Wales)                                                                                                                                                                     (see paragraphs 21 to 26)
                                                             e   medical royal colleges and other                                                                                                                                                                   b   whether you have sufficient information 
                                                                        authoritative sources of specialty specific                                                                                                                                                            to prescribe safely, for example if you have 
                                                                        clinical guidelines.                                                                                                                                                                                   access to the patient’s medical records 
                                                                                                                                                                                                                                                                               and can verify relevant information (see 
                                             16   You should be careful about using medical                                                                                                                                                                                    paragraphs 27 to 33)
                                                             devices for purposes for which they were not                                                                                                                                                           c  whether y                                 ou can establish two-way dialogue, 
                                                             intended.                                                                                                                                                                                                         make an adequate assessment of the 
                                             17  You should make sure that anyone you delegate                                                                                                                                                                                 patient’s needs and obtain consent (see 
                                                             responsibility for dispensing or administering                                                                                                                                                                    paragraphs 34 to 38)
                                                             medicines to is competent to do what you                                                                                                                                                               d    whether you can share information 
                                                             ask.5 Advice on training for dispensing support                                                                                                                                                                   appropriately after an episode of care (see 
                                                             staff can be obtained from the General                                                                                                                                                                            paragraphs 53 to 58).
                                                             Pharmaceutical Council and Pharmaceutical 
                                                             Society of Northern Ireland (PSNI).                                                                                                                                                    Does the mode of consultation meet the 
                                             18  Where relevant, if you don’t wish to prescribe                                                                                                                                                     individual needs of the patient and support 
                                                             due to a conscientious objection, you should                                                                                                                                           safe prescribing? 
                                                             follow our explanatory guidance on ‘Personal                                                                                                                                           21  Patients may prefer to access healthcare services 
                                                             beliefs and medical practice’.                                                                                                                                                                         face-to-face or through remote consultations 
                                             19  You should not collude in the unlawful                                                                                                                                                                             via telephone, video-link or online, depending on 
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                                                             advertising of prescription-only or unlicensed                                                                                                                                                         their individual needs and circumstances.  Where 
                                                             medicines to the public by prescribing via                                                                                                                                                             different options exist, and when it is within your 
                                                                                                                                                                                                                                                                    power, you should agree with the patient which 
                                                                                                                                                                                                                       6
                                                             websites that breach advertising regulations.                                                                                                                                                          mode of consultation is most suitable for them. 
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