MDU reports doctors are concerned about prescribing remotely, as new GMC guidance published

Remote consultations have become the norm for many doctors during the pandemic and concerns around prescribing remotely have led doctors to seek advice from the Medical Defence Union (MDU).

The MDU, the UK’s leading medical defence organisation, said it had seen an increase in doctors wanting advice about prescribing remotely during 2020, in some cases to patients stuck overseas and in others to patients who require long term medication but who have not been assessed face to face for their usual monitoring, because of the pandemic.

The MDU is advising its members to proceed with caution when prescribing remotely. This coincides with the publication of the GMC’s Good practice in prescribing and managing medicines and devices which is published today. 

Dr Caroline Fryar, head of advisory services at the MDU commented:

“With many consultations moving online during the pandemic, doctors have become even more adept at assessing patients virtually. Prescribing as part of a remote consultation is often entirely safe and reasonable as long as the prescribing doctor has enough information about the patient, can make an adequate assessment and have a proper dialogue with the patient.

However, as ever, doctors need to apply their judgement and remain alert to situations in which a face-to-face consultation may be needed.

In addition, prescribing to patients overseas presents ethical and legal difficulties for doctors, who need to consider whether they have appropriate registration and indemnity among other considerations.

The GMC’s new guidance on prescribing, which comes into effect on 5th April also explains that, when prescribing remotely, doctors must consider safeguarding concerns and ‘circumstances in which a face-to-face consultation may be more appropriate [e.g.] if a patient does not have a safe and confidential place to access healthcare remotely, for example due to domestic abuse [or if] you are concerned that a patient may be unable to make a decision freely because they are under pressure from others, or you are unsure of a patient’s capacity to decide about treatment’ (paragraph 22).

In a recent survey, the MDU found that the majority (77 per cent) of GP respondents believed that remote working practices, including prescribing, will continue post pandemic. The MDU also found that

·        97 per cent of respondents increased their use of phone consultations

·        75 per cent increased their use of video consultations

·        55 per cent increased their use of online triage systems

During 2020, the most common reasons for MDU members to request advice and support with prescribing included:

·        Prescribing ‘off-label’ medicines

·        Adverse events e.g. prescribing to a patient with a known allergy, drug interactions

·        Prescribing for patients overseas and remotely

·        Prescribing for patients who needed additional monitoring

MDU members with concerns about prescribing are encouraged to contact the MDU’s advisory team who can offer further support and guidance in this area.