Case study one

Alex is an IP who has spent a year working in a GP practice running his clinics, he has recently started a new role as a prescriber working remotely doing telephone consultations for out-of-hours. Whilst he has some experience of telephone consultations during his time at the GP practice, this was only for patients that he had seen at some point during his clinics and had a good understanding of their medical records.

Alex is a bit concerned about prescribing remotely for a range of patients that he has not seen before and prescribing outside of his competency. He does not want to turn the role down as he feels it is good for his development as a prescriber.

Consideration Points

• With remote services becoming increasingly popular, it is important that any prescriber feels both competent and safe to provide this service for their patients.

• Alex needs to remember he is accountable and responsible for each prescription he signs.

• Is there a process for when he can refer a patient to a medical prescriber whilst working remotely? Is he able to distinguish when a patient may need a physical examination and where to signpost the patient to?

• Making a list of all the additional skills required for remote prescribing could be useful, such as improving history taking skills. Could he undertake any additional courses or training that would support him in remote prescribing?

• Discussing with other prescribers how they may prescribe in this environment, considering a workplace mentor can help.

• Again, it is important to remember Alex is responsible and accountable for every prescription he signs. The archived document from the Department of Health Improving patients' access to medicines: A guide to implementing nurse and pharmacist independent prescribing within the NHS in England -discusses the responsibility and accountability of prescribers.

Further Support

GMC Prescribing guidance: Remote prescribing via telephone, video-link or online

GPhC Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet

GMC Remote patient consultations and prescribing