Legal Basis of Prescribing

Key Components of Prescribing:
- Assessing the patient’s clinical condition.
- Taking comprehensive histories: medical, medication, and social.
- Deciding on the management approach, including whether to prescribe.
- Identifying appropriate products for treatment if necessary.
- Advising patients about potential effects and risks associated with medications.
- Writing and providing a prescription upon patient agreement.
- Monitoring the patient's response to medication and lifestyle adjustments.

2021 GPhC Standards: Relevant to MPharm and Foundation Training Year.
Many standards pertain to prescribing activities.
Requirement of 90 hours of supervised practice during foundation training.
To qualify as a pharmacist prescriber:
- Pass the MPharm.
- Achieve foundation competencies.
- Pass the registration assessment.

Development of Prescribing Skills:
- Training during foundation will dictate initial prescribing abilities.
- Anticipate an increase in breadth 폭 over time; may specialize in certain areas (depth).
- Essential to prescribe within personal practice and competence limits.
- Consider how to demonstrate your scope of practice effectively.

Accountability Aspects:
- Prescribers are accountable throughout their careers for their practice.
- Accountability to key stakeholders:
  - The patient
  - The prescriber themselves
  - The wider public and society
  - Their employer
  - Their profession

Prescriber visits a patient in an intermediate care ward.
Senior nurse requests an amendment to the patient's drug chart:
- Patient’s wife insists on a higher metformin dose (850 mg bd vs 500 mg bd).
- Introduces the medication box as evidence.
Consideration Needed: Should the dose be amended?

Prescriber receives a job offer from an internet hair loss service.
Service plans to provide finasteride based on an online survey completion.
Key Questions Prior to Job Acceptance: What should the prescriber inquire about?

Assessment of a patient requesting treatment for vaginal thrush.
Physical Examinations Required Before Prescribing: What examinations should be conducted?

Critical Aspects of Record Keeping:
- Clarify reasons for prescription choices.
- Confirm consent for examination was obtained.
- Maintain clear and appropriate records.
- Ensure records can justify decisions and actions taken.
- Consider scenario where a coroner might need explanation of actions.