PATIENTS AND PRESCRIBING: RIGHTS AND RESPONSIBILITIES• Am I right, that as an NHS patient my doctor must prescribe for me whatever Iwant?Under the NHS regulations your GP must prescribe for you any drugs that he feels are needed foryour care. This decision of what or whether to prescribe will be a clinical decision based on thepresenting symptoms and history. A patient is entitled under the NHS to drugs that the doctorbelieves are necessary, not what the patient feels should be prescribed. GPs are responsible for allprescribing decisions they make and for any consequent monitoring that is needed as a result of theprescription given.The Department of Health lists all drugs that the NHS is prepared to pay for in a book called the DrugTariff. It is likely that most, if not all, the drugs you need are available through the NHS, however theDrug Tariff does have exceptions. Some drugs, like Viagra, listed in Schedule 11 will only be offeredon the NHS to patients suffering from specified conditions. Similarly some products other than drugs,such as high energy or gluten free foods, are listed as ‘Borderline Substances’ and may only beprescribed at NHS expense in defined circumstances. Other drugs or substances, listed in Schedule10, cannot be prescribed at all on the NHS. Examples are Evening Primrose Oil, many vitamins, bathpreparations, cough syrups and expensive brand names of some drugs.(Viagra and “single” mumps, measles and rubella vaccines will be discussed in detail in questionsbelow)• If I would like a drug that is not available on the NHS can my doctor write me aprivate prescription for it?Any doctor can write a private prescription for a patient if they feel it is clinically appropriate and theyare happy to take responsibility for that prescribing decision. Under the NHS regulations, a GP or hisdeputy can write a private prescription for a patient but cannot charge the patient for writing a privateprescription if the patient is registered for NHS care with that GP or any other GP in the samepractice.The only exceptions to this rule are when an NHS GP writes either a private prescription for drugsthat are requested by the patient “just in case” of the onset of illness while outside the UK, or elsewhen a private prescription is required for the prevention (chemoprophylaxis) of malaria.
Julian Pavey ● 2185d