GMC – New guidance on self-prescribing

March 5, 2013

The General Medical Council (GMC) has issued new guidance, which came into effect on 25th February 2013, entitled ‘Good practice in prescribing and managing medicines and devices (2013)’. The new guidance includes the stark warning that doctors must avoid self-prescribing or prescribing for anyone else with whom they have a close personal relationship.

Risks of self-prescribing

The new guidance has been released against a backdrop of a significant rise over the last 3 years, of the number of doctors who have been referred to the GMC for fitness to practise hearings for self-prescribing or for the informal treatment of family, friends or colleagues. Many of these doctors were reported to the GMC by pharmacists or colleagues.

The most common drugs self-prescribed by doctors are benzodiazepines, strong painkillers and antibiotics, leading the GMC to be concerned that doctors who self-prescribe may develop or feed addictions, as well as putting their own health at risk by not seeking appropriate and independent medical care.

Another risk associated with doctors prescribing for family and friends on an ad hoc basis, is that unwittingly, the doctor may cause the patient to suffer adverse interactions with medication, as a result of either the doctor’s lack of overall knowledge of the patient’s medical history and/or the patient’s GP not being told about the ad hoc treatment, where this does not get recorded on the patient’s medical records.

It has long been recognised in most quarters that all patients, including doctors and their family/friends need to be treated by clinicians that are not emotionally involved in their medical decisions, to enable them to access the best medical care available.

Not all doctors agree with guidance

Some doctors have commented that this constitutes over the top regulation and have asked for the potential risks to be kept into perspective. However a decision seems to have been taken that the irresponsible actions of the minority justifies the new stance.

If the need for self-prescribing arises

If a doctor finds themselves in a situation where they feel they have no choice but self-prescribing, then they need to explain and justify their actions, recording why there was no alternative. They also need to inform their own GP of the situation.

In an emergency a doctor has an ethical duty to provide immediate medical care to anyone who needs it, which includes family and friends, where there is no one else available, which has not changed.

Doctors who breach the guidelines of the GMC risk being referred to the GMC for allegations that their fitness to practise is impaired. Depending on their specific circumstances they may risk erasure or a lengthy suspension.

Our lawyers have experience in representing doctors who are accused of self-prescribing and prescribing for their family.

The new GMC self-prescribing guidelines at paragraphs 16-19 state the following:

“Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship.

Controlled medicines present particular dangers, occasionally associated with drug misuse, addiction and misconduct. You must not prescribe a controlled medicine for yourself for someone close to you unless:

  1. no other person with the legal right to prescribe is available to assess and prescribe without a delay which would put you, or the patient’s, life or health at risk or cause unacceptable pain or distress, and
  2. the treatment is immediately necessary to save a life, or avoid serious deterioration in health, or alleviate otherwise uncontrollable pain or distress.

If you prescribe for yourself or someone close to you, you must:

  1. Make a clear record at the same time or as soon as possible afterwards. The record should include your relationship to the patient (where relevant) and the reason it was necessary for you to prescribe.
  2. Tell you own or the patient’s general practitioner (and others treating you or the patient, where relevant) what medicines you have prescribed and any other information necessary for continuing care, unless (in the case of prescribing for somebody close to you) they object.”

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