Medicines management and prescribing policy

Medicines form an increasingly important part of modern healthcare. The medicines themselves and the legislation surrounding their use are becoming increasingly complex. This document describes the policy to ensure that all aspects of the management of medicines within Clinically Sound Ltd (CSL) comply with current legislation and ensure the safety of all clinical and non-clinical staff and patients.

CSL recognises that a clinician will be working out of area, and it may not always be possible to know what the local guidelines are on prescribing. In these circumstances the clinician will be expected to adhere to National guidance as set out in NICE Guidance and NICE CKS guidance. As CSL is based in Devon the clinician will be encouraged to know, use and have access to the ‘South and West Devon Formulary’ as a guide. 

All clinicians will have access to these guidelines via the internet, mobile phone applications or a similar alternative, at all times. 

A clinician may not prescribe medications that fall outside his/her competency and should not prescribe medicines that he/she do not feel comfortable prescribing. In situations where this arises then a clinician would be encouraged to speak with colleagues who may have the competency to prescribe the medication. 

A clinician should not consider changing a patient’s regular medications unless a full medication history is available. If appropriate to prescribe, then the minimum needed to keep the patient safe should be issued and refer the patient back to their regular practitioner. Minimum in this situation is enough for the patient to arrange a review with their usual practitioner. The length of time that the prescription is for is at the discretion of the prescribing clinician. 

Private prescriptions can be produced electronically and sent directly to a nominated pharmacy, or a hard copy prescription can be produced and posted to the patient.

The electronic prescription is generated using the medical software, Medesk and then, via a digital prescribing platform, is sent electronically to the nominated pharmacy. The current clinician is registered with ‘Cloud Rx’, who instantly transmit digitally signed electronic prescriptions to their pharmacy in Leeds and are then processed and dispatched to the patients address. The clinician also has registration with an alternative service, ‘Signature Rx’, where digitally signed prescriptions can be sent to any nominated pharmacy for the patient to collect.

Prior to any prescription being issued a full and detailed history will be taken and fully recorded in the patient’s records. 

All patients who require a prescription must produce photographic ID prior to a script being issued. 

As a guide the maximum length of a prescription will be 28 days, but the clinician has discretion. 

CSL does not prescribe Schedule 2, 3 or 4 controlled drugs. 

All controlled drugs will be discouraged however, if appropriate, schedule 5 preparations can be prescribed but keeping the quantities to a realistic minimum, with one week being CSL’s guidance. 

CSL has no physical stock of medicines that can or will be issued.

CSL prescriptions are generated individually and can only be accessed via encrypted software which is password protected.

CSL holds no physical blank prescriptions.

Patients will be encouraged to consent to sharing all prescription information with their own registered GP. Scripts could be refused on occasion if consent is not granted and creates doubt in the mind of the prescriber.

CSL insist all prescriptions must be produced robustly and only if clinically appropriately.  It is recognised that some medications/ prescriptions could be abused. For these medications, as for all controlled drugs, they will only be issued following a video consultation and photographic ID confirmation. They will not be issued if there is no consent to share the information with their own NHS GP. Script lengths will be kept to a minimum and repeat prescriptions not possible. Our clinician is trained in Substance misuse and there will be regular audits of these medications.

The weekly Clinical Governance meetings have a dedicated section assigned to prescribing and specifically the issue of controlled medications and other medications that are open to abuse will be closely monitored including audit. 

The prescribing pattern of a clinician will be audited and reviewed on a regular basis and any concerns will be raised with the clinician.