A registrar survival guide - Prescribing

Prescribing is part of being a GP. It can pose problems and accounts for a huge portion of the NHS budget.

Effective prescribing
Is the item you are prescribing the most effective for the job you intend it to do? Remember to consider the needs of the patient and any potential side-effects.

Private prescriptions
Private prescriptions crop up from time to time. Remember, some NHS patients will be prescribed private prescriptions, such as sildenafil, if they do not meet the NHS requirements for funding.

Cost
Cost is unfortunately tied into the effectiveness. Newer, or sometimes more effective therapies can cost more. Most PCTs have prescribing restrictions. Some practices also use a computer system which, when prescribing, alerts you to a cheaper alternative.

Although this does sound quite intrusive; it is a helpful reminder.

Secondary care prescribing
Advice from our secondary care colleagues for certain therapies are suggestions only and, as the prescribing GP, you can disagree. You have the ultimate legal responsibility for any prescriptions, so if you do disagree, do not feel afraid to query it.

Postcode lottery
This is an unfortunate practicality if you work across boarders of a PCT. Some of your patients may be able to get drug X, while others living elsewhere cannot. This may require further discussion with the PCT or your soon-to-be commissioning colleagues.

ESSENTIALS CHECKLIST
  • An awareness of the most effective drug treatments for each patient.
  • A cost-effective approach.
  • Responsibility for your own prescribing.
  • Dr Syed Haque is a GPST3 in East Anglia.

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