A joint set of principles has been issued by healthcare regulators to help protect patient safety and welfare when accessing medication online or over the phone.  These principles apply to all healthcare professionals involved in providing consultations and medication to patients remotely, including doctors, nurses, pharmacists, dentists and opticians.

The jointly-agreed high level principles for good practice in remote consultations and prescribing set out the good practice expected of healthcare professionals when prescribing medication online.

Key principles

1. Make patient safety the first priority and raise concerns if the service or system they are working in does not have adequate patient safeguards including appropriate identity and verification checks.
2. Understand how to identify vulnerable patients and take appropriate steps to protect them.

3. Tell patients their name, role and (if online) professional registration details, establish a dialogue and make sure the patient understands how the remote consultation is going to work.

4. Explain that:
   1. They can only prescribe if it is safe to do so.
   2. It’s not safe if they don’t have sufficient information about the patient’s health or if remote care is unsuitable to meet their needs.
   3. It may be unsafe if relevant information is not shared with other healthcare providers involved in their care.
   4. If they can’t prescribe because it’s unsafe they will signpost to other appropriate services.

5. Obtain informed consent and follow relevant mental capacity law and codes of practice.
6. Undertake an adequate clinical assessment and access medical records or verify important information by examination or testing where necessary.
7. Give patients information about all the options available to them, including declining treatment, in a way they can understand.
8. Make appropriate arrangements for after care and, unless the patient objects, share all relevant information with colleagues and other health and social care providers involved in their care to support ongoing monitoring and treatment.
9. Keep notes that fully explain and justify the decisions they make.
10. Stay up to date with relevant training, support and guidance for providing healthcare in a remote context.

Existing standards

The ten principles, underpinned by existing standards and guidance, include that healthcare professionals are expected to:

1. Understand how to identify vulnerable patients and take appropriate steps to protect them
2. Carry out clinical assessments and medical record checks to ensure medication is safe and appropriate
3. Raise concerns when adequate patient safeguards aren’t in place.

The publication follows the release, in September, of a joint statement by healthcare regulators, which included a commitment to work together and with partner organisations to develop shared principles on remote consultations and prescribing.

Further information and guidance

Links to relevant information and guidance published by healthcare regulators:

General Dental Council

• Standards for the dental team (2013)

General Medical Council

• Good medical practice (2013)
• Good practice in prescribing and managing medicines and devices (2013)
• Ethical hub resource on remote consultations
• Ethical hub resource on adult safeguarding
• Protecting children and young people; the responsibilities of all doctors (2018)

General Pharmaceutical Council

• Guidance for registered pharmacies issuing prescriptions at a distance including on the internet (2019)
• Standards for pharmacy professionals (2017)

The Health and Care Professions Council

• Meeting our Standards
• Standards for Prescribing (2019)

Nursing and Midwifery Council

• Professional code
• Standards for prescribers
• FAQ on remote prescribing: what do I need to consider as a nurse, midwife or nursing associate when medicines are prescribed remotely?