Standard operating procedure

Remote Prescribing Procedure

How prescribers at [Organisation Name] prescribe safely for patients seen remotely, ensuring an adequate assessment, sufficient information, communication with the patient's general practitioner (GP), particular caution with higher-risk medicines, and full documentation of every prescribing decision

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What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Procedure
  • 6. High-risk medicines and safeguards
  • 7. Records
  • 8. Related documents
  • 9. Review and version control
  • 10. Disclaimer

Legislation & standards it maps to

  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 12 (Safe care and treatment)
  • General Medical Council, Good practice in prescribing and managing medicines and devices (2021), including its guidance on remote prescribing and on prescribing in remote consultations
  • General Pharmaceutical Council (GPhC), Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet (2022)
  • Human Medicines Regulations 2012 (SI 2012/1916, as amended) - prescribing and supply of prescription-only medicines
  • The Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001 (SI 2001/3998, as amended) - where controlled drugs are involved
  • The Summary of Product Characteristics (SmPC) for each medicine prescribed, and Medicines and Healthcare products Regulatory Agency (MHRA) guidance
  • Data Protection Act 2018 and the UK General Data Protection Regulation

Who it applies to

All prescribers (doctors, and where appropriate nurse and pharmacist independent prescribers), supervising and responsible clinicians, registered pharmacists, clinical and triage staff supporting remote consultations, the superintendent pharmacist where the service includes an online pharmacy, and the registered manager or [Insert Job Title] at [Organisation Name] involved in prescribing for patients who are not physically present

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Adequate assessment
An assessment thorough enough, for the medicine and the patient concerned, to reach a safe prescribing decision.
Antimicrobial stewardship
Using antibiotics and similar medicines carefully and only when needed, so they keep working and resistance does not build up.
Antimicrobials
Medicines that treat infections, including antibiotics, antifungals and antivirals.
Best interests
A decision made for someone who cannot decide for themselves, choosing the option that is best for them.
Blood pressure monitoring
Regularly measuring the pressure of blood in the arteries to check that a medicine is safe and working.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Contemporaneous record
A note made at the time of, or immediately after, the event it describes, rather than written up later from memory.
Contraindication
A reason a particular medicine should not be given to a particular person, because it would be unsafe for them.
Controlled drug (CD)
A medicine whose supply, storage and records are tightly restricted by law because of its potential for misuse.
Data Protection Act 2018
The UK law that sits alongside the UK GDPR and governs how personal information must be handled.
Diversion
When medicine intended for one person is passed on, sold or used by someone else.
Formulary
The agreed list of medicines a service is allowed to prescribe.
Gabapentinoids
A group of medicines (such as gabapentin and pregabalin) used for nerve pain and epilepsy that can be misused and cause dependence.
General Medical Council (GMC)
The body that registers doctors in the UK and sets the standards they must follow.
General Pharmaceutical Council (GPhC)
The body that registers pharmacists and pharmacies in Great Britain and sets the standards they must follow.
General practitioner (GP)
A doctor based in the community who provides everyday medical care and usually holds a patient's main medical record.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The law setting out the fundamental standards that registered health and care providers must meet, enforced by the Care Quality Commission.
Human Medicines Regulations 2012
The main UK law governing how medicines are authorised, prescribed, supplied and sold.
Indication
The medical reason a particular medicine is being prescribed.
Informed consent
Agreement to treatment given freely after the risks, benefits and alternatives have been clearly explained.
Interaction (drug interaction)
When one medicine changes the effect of another, which can make treatment less effective or cause harm.
Medicines and Healthcare products Regulatory Agency (MHRA)
The UK body that regulates medicines and medical devices and issues safety advice about them.
Misuse of Drugs Act 1971
The UK law that classifies controlled drugs and makes their unlawful supply or possession a criminal offence.
Misuse of Drugs Regulations 2001
The rules setting out how controlled drugs may lawfully be prescribed, supplied, stored and recorded.
Multiple-supplier pattern
When a patient gets, or tries to get, the same or similar medicine from more than one prescriber or service, which can be a sign of misuse.
National Institute for Health and Care Excellence (NICE)
The body that produces evidence-based guidance on treatments and care for use across health and social care.
Near miss
An event that could have caused harm but did not, by chance or because it was caught in time.
Non-medical independent prescriber
A trained nurse, pharmacist or other health professional, who is not a doctor, but is qualified to prescribe medicines in their own right.
Off-label use
Prescribing a licensed medicine for a purpose, dose or group of patients not covered by its official licence, where this is clinically justified.
Opioids
Strong painkillers related to morphine that carry a high risk of dependence, misuse and overdose.
Prescriber
A doctor or non-medical independent prescriber who takes clinical responsibility for authorising a prescription within their area of competence.
Prescription-only medicine (POM)
A medicine that may lawfully be supplied only on the instruction of an appropriate prescriber.
Registered manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Regulated activity
A type of care or treatment the law requires a provider to register with the regulator to deliver.
Regulation 12 (Safe care and treatment)
The part of the 2014 regulations that requires care and treatment to be provided in a safe way, including the safe use of medicines.
Remote prescribing
Issuing a prescription for a patient who is not physically present, after assessing them by online questionnaire, telephone, video or other digital means.
Safeguarding
Protecting people's health, wellbeing and rights and keeping them safe from abuse, harm or neglect.
Safety-netting
Clear advice telling the patient what to expect, what warning signs to watch for, and when and how to seek further help.
Shared care
An arrangement where responsibility for a patient's treatment is shared between a specialist or service and the patient's regular doctor, under an agreed plan.
Signposting
Directing a patient to another, more appropriate service or source of help.
Single assessment framework
The structure the Care Quality Commission uses to judge a service, built around quality statements and five key questions (safe, effective, caring, responsive, well-led).
Standard Operating Procedure (SOP)
A written, step-by-step instruction setting out how a particular task must be carried out consistently and safely.
Summary of Product Characteristics (SmPC)
The official document for a medicine that sets out its licensed uses, dosing, contraindications, warnings and cautions.
Superintendent pharmacist
The senior pharmacist legally responsible for the safe running of a registered pharmacy business.
Telehealth
Providing health care at a distance using technology such as telephone, video or online tools.
Triage
Assessing patients to decide how urgent their needs are and what type of care or clinician they require.
UK General Data Protection Regulation (UK GDPR)
The UK's main data-protection law governing how personal information is collected and used.
UK Health Security Agency (UKHSA)
The national body responsible for protecting the public from infectious diseases and other health threats.
Unlicensed medicine
A medicine that does not have an official UK licence for the use intended, which a prescriber may use only when clinically justified.

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