Here’s how to answer patients’ questions about the months to come, says Dr Karen Ellison, medicolegal consultant at Medical Protection
Patients requesting extra prescription medicines amid no-deal Brexit uncertainty is not an uncommon scenario in general practice.
With an increasing stack of repeat prescriptions waiting to be signed by GPs, it is crucial not to rush this important task or be pressured by patients into overprescribing. The practice should have a good repeat-prescribing policy in place, and if possible, practices should facilitate their GPs to have a dedicated time to sign repeat prescriptions.
Although it is hoped that Brexit will not affect the provision of healthcare in the UK, it is important that practices are aware of what steps to take should patients face delays obtaining their routine medications.
Practice managers can refer to the GMC’s ethical guidance and remind their GPs that they must:
- Prescribe drugs or treatment including repeat prescriptions, only when they have adequate knowledge of the patient’s health, and are satisfied that the drugs or treatment serve the patient’s needs[i]
- Provide effective treatments based on the best available evidence
- Check that the care or treatment they provide for each patient is compatible with any other treatments that the patient is receiving, including, where possible, self-prescribed over-the-counter medications
- Provide the best service possible within the resources available, taking account of their responsibilities towards their patients and the wider population.[ii]
GPs are responsible for the prescriptions they sign, their decisions and actions when they supply and administer medicines and devices or instruct others to do so.
GPs must be prepared to explain and justify their decisions and actions when prescribing, administering and managing medicines. While stockpiling medicines may reduce the supplies for others, practices and GPs who are concerned that inadequate resources could impact on some high-risk patients should raise concerns with their local CCG.
Discussions and rationale for the approach should be recorded comprehensively in the patient’s notes.
New patients registering to join the practice may come with a long list of medications they are already being prescribed. Practice staff should not simply add this to the patient’s prescription list; an appropriate new patient review should be carried out.
Good communication is key in avoiding a complaint. While GPs may have done their best in being open and honest with their patients, some patients will remain angry about not being able to stock up their prescriptions ahead of a no-deal Brexit. During the consultation, patients should be offered the practice’s complaints process and follow-ups should they remain dissatisfied.
If their complaint is made online, practices should limit their public response as they have a duty of patient confidentiality. Practice managers should acknowledge the complaint and invite the patient to contact the practice directly to discuss any concerns. This will ensure confidentiality is maintained and avoid any potential grievances being played out in a public forum.
For further advice, contact your medical defence
[i] General Medical Council (GMC) ethical guidance Prescribing and managing medicines and devices
[ii]General Medical Council (GMC) ethical guidance Planning, using andmanaging resources