GMC: Good practice in prescribing and managing medicines and devices: Summary

SJT Textbook: Good Practice in Prescribing and Managing Medicines and Devices

GMC Prescribing Guidance

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

🎯 THE CORE PRINCIPLE

Prescribing carries significant responsibility. Doctors must only prescribe when they have enough information about the patient’s condition, medicines history, allergies, co-morbidities, and risks. Good practice includes using evidence-based guidance, checking interactions, collaborating with pharmacists, preventing errors, and ensuring the patient understands how to use their medicine safely.

This guidance applies to all prescribing contexts—face-to-face consultations, remote prescribing, repeat prescriptions, shared care, controlled drugs, unlicensed medicines, and device use. The MSRA SJT tests safe decision-making, avoidance of harm, strong documentation, avoidance of self-prescribing, and clear communication with patients and colleagues.

Unsafe prescribing, poor communication, or failing to check essential information frequently appear in SJT pitfalls. High-scoring candidates prioritise safety, clarity, and accountability.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Prescribe only when you have adequate, up-to-date knowledge of the patient.
2. Check allergies, interactions, contraindications, and recent monitoring before prescribing.
3. Document indication, dose, risks, and advice clearly.
4. Use evidence-based sources such as BNF, BNFC, NICE, and MHRA alerts.
5. Communicate promptly with other clinicians after remote or shared-care prescribing.
6. Avoid self-prescribing and prescribing for those close to you unless in exceptional emergencies.
7. Review medicines regularly and deprescribe safely when appropriate.
8. Report adverse drug reactions and incidents using systems such as the Yellow Card Scheme.
9. Seek advice for controlled drugs, unlicensed medicines, or high-risk prescribing.
10. Use pharmacists and digital safety systems to improve accuracy and reduce harm.

These traps ignore safety, good documentation, and GMC prescribing duties.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I will check allergies, interactions, and recent monitoring.”
* “I will document the indication and advice clearly.”
* “I must avoid self-prescribing due to conflicts of interest.”
* “I will report this adverse reaction through the Yellow Card Scheme.”
* “I will liaise with pharmacy to ensure safe management.”

P – Patient knowledge
R – Review allergies and interactions
E – Evidence-based guidance
S – Safety systems
C – Communicate changes
R – Review regularly
I – Incident reporting
B – Beware self-prescribing
E – Escalate when unsure

📋 QUICK FAQ

Can I prescribe remotely?
Yes, but only if you have enough information to do so safely and appropriate safeguards are in place. Can I prescribe for myself or family?
Generally no—conflicts of interest and risk of unsafe practice make this inappropriate unless in exceptional emergencies. What if I am unsure about a medicine?
Check the BNF, consult senior colleagues, or involve pharmacists. Do I need to review repeat prescriptions?
Yes—regular reviews are essential to ensure medicines remain safe and necessary. What about unlicensed medicines?
Explain the unlicensed status, provide clear information, and use them only when clinically justified.

📚 GMC ANCHOR POINTS

• Safe prescribing – Good practice in prescribing and managing medicines
• Avoid conflicts of interest – Good Medical Practice
• Clear communication with the team – Continuity of care
• Incident reporting – Yellow Card Scheme and GMC standards
• Treat within competence – Good Medical Practice
• Duty to review and ensure ongoing safety – Repeat prescribing standards

💡 MINI PRACTICE SCENARIO

A patient requests a repeat prescription for a controlled drug you have never prescribed for them. No recent monitoring is recorded. Best action: Refuse to prescribe until reviewing the patient, verifying need, and ensuring safe monitoring. Why: Prescribing without adequate knowledge breaches GMC safety requirements and risks harm.

🎯 KEY TAKEAWAYS

✓ Prescribe only with sufficient patient knowledge
✓ Avoid self-prescribing and high-risk shortcuts
✓ Check allergies, interactions, and monitoring
✓ Communicate changes promptly
✓ Document everything clearly
✓ Use pharmacists and safety systems
✓ Review and report issues to protect patients

🔗 RELATED TOPICS

* → Duty of Candour
* → Medicines Safety and Incident Reporting
* → Shared Care and Communication
* → Confidentiality and Information Sharing
* → Professional Boundaries

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

A patient you have never met requests antibiotics via a telephone consultation, insisting they “always get this treatment” and do not want to come in. You cannot verify allergies or past reactions.

Options:
A. Prescribe to avoid disappointing the patient
B. Decline and ask them to attend for assessment
C. Check their record and arrange an urgent face-to-face review
D. Prescribe a lower dose to reduce harm
E. Document the discussion clearly
F. Ask a colleague to prescribe instead
G. Provide safety-netting advice
H. Prescribe and ask them to call back if worse

Example SJT — Rank 5 (best → worst)

A colleague is signing repeat prescriptions without reviewing patients due to workload pressures.

Options:
A. Raise concerns with a senior or prescribing lead
B. Offer to review urgent cases with them
C. Document the concern and follow local policy
D. Ignore the issue to maintain team harmony
E. Ask them to just “be more careful”