GPs should ignore OTC prescribing bans if patient care at risk, says GMC

GPs should ignore bans on prescribing drugs available OTC if they believe the policies put patient care at risk, the GMC has said.

Pharmacy: GPs face bans on drugs available OTC
Pharmacy: GPs face bans on drugs available OTC

GMC guidance on Raising and acting on concerns about patient safety states it is up to GPs to make a professional judgment on whether ‘local developments' could have 'an adverse impact on patient care’.

This guidance can be considered when deciding whether to implement CCG bans on providing patients with prescriptions for drugs that are also available OTC, the regulator told GPonline.

CCG have rolled out local bans on prescribing drugs available OTC, despite warnings from the BMA that GPs could be in breach of their contracts if they refuse to prescribe medicines their patients need. Local commissioners have imposed the bans without waiting for the results of an NHS England consultation on proposals for a nationwide block on GPs prescribing drugs available OTC, which runs until October.

GP prescribing

The GMC accepts that doctors do not prescribe within ‘a financial vacuum’ and says available resources should be taken into account when deciding whether to prescribe drugs that are available through other means.

Its Good medical practice guidance says ‘advising patients on the purchase of over the counter medicines’ falls under its definition of ‘prescribing’, suggesting GPs can still fulfil their duty of providing these drugs without having to sign a prescription.

However, the GMC told GPonline that its guidance informs GPs that the care of a patient must be ‘their first concern’.

A spokesman added: ‘This guidance also makes it clear that doctors must provide a good standard of care, provide effective treatments based on the best available evidence and take all possible steps to alleviate pain and distress.

‘We also say that doctors must give priority to patients on the basis of their clinical need if these decisions are within their power.

Patient safety

‘If inadequate resources or policies prevent doctors from doing this, and they feel that patient safety or comfort may be seriously compromised, they should put this right if possible and must raise their concern in line with our guidance and their workplace policy, making a record of the steps they’ve taken.'

The clarification follows warnings from the GPC that GPs could be vulnerable to receiving complaints if they refuse to prescribe patients treatments they clinically need, even if that treatment is also available without prescription.

NHS England is currently consulting on plans to ‘drive out wasteful’ drug prescriptions, which includes proposals to ban GPs from prescribing 3,200 drugs that are available OTC.

A GMC spokeswoman said: ‘Our guidance on Raising and acting on concerns about patient safety provides further information on the steps we consider it reasonable for doctors to take if local developments are having an adverse impact on patient care.

‘It would be for the doctor to make a professional judgment about whether this is the case and to act accordingly.

‘However, we do of course recognise that healthcare does not exist in a financial vacuum and that health systems in the UK have finite resources.

‘Our core guidance Good medical practice says that doctors must make good use of the resources available to them. In our Leadership and Management guidance, we recognise treatment options that can be offered to patients may be affected by resource limits.’

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