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Good practice in prescribing and managing medicines and devices

Sharing information with colleagues

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You must contribute to the safe transfer of patients between healthcare providers and between health and social care providers. This means you must share all relevant information with colleagues involved in your patient’s care within and outside the team, including when you hand over care as you go off duty, when you delegate care or refer patients to other health or social care providers. This should include all relevant information about their current and recent use of other medicines, other conditions, allergies and previous adverse reactions to medicines.

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It is essential for safe care that information about medicines accompanies patients (or quickly follows them, for example on emergency admission to hospital) when they transfer between care settings.11 

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See Keeping patients safe when they transfer between care providers – getting the medicines right (Royal Pharmaceutical Society, July 2011).

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If you prescribe for a patient, but are not their general practitioner, you should check the completeness and accuracy of the information accompanying a referral. When an episode of care is completed, you must tell the patient’s general practitioner about:

  1. changes to the patient’s medicines (existing medicines changed or stopped and new medicines started, with reasons)
  2. length of intended treatment
  3. monitoring requirements
  4. any new allergies or adverse reactions identified,12unless the patient objects or if privacy concerns override the duty, for example in sexual health clinics.
12

See the EQUIP (Errors – Questioning Undergraduate Impact on Prescribing) study regarding inappropriate delegation of responsibility for writing up discharge summaries to junior staff with insufficient pharmacology training or knowledge of patients. 

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If a patient has not been referred to you by their general practitioner, you should also:

  1. consider whether the information you have is sufficient and reliable enough to enable you to prescribe safely; for example, whether:
    1. you have access to their medical records or other reliable information about the patient’s health and other treatments they are receiving
    2. you can verify other important information by examination or testing
  2. ask for the patient’s consent to contact their general practitioner if you need more information or confirmation of the information you have before prescribing. If the patient objects, you should explain that you cannot prescribe for them and what their options are.
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If you are the patient’s general practitioner, you should make sure that changes to the patient’s medicines (following hospital treatment, for example) are reviewed and quickly incorporated into the patient’s record. This will help to avoid patients receiving inappropriate repeat prescriptions and reduce the risk of adverse interaction.13 

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See  (National Prescribing Centre, 2008)

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