Induction 7: Prescribing
Prescribing
Whilst in the ED you will be prescribing a number of drugs for patients. This is done electronically via EPMA for adults and children. Fluids for children are still currently on paper charts. Please ensure you follow the hospitals antibiotics prescribing formulary. This can be accessed from the intranet via the ‘Pharmacy’ link.
You can also download the MicroGuide App onto your phone from the AppStore. (This can be really helpful)!
Prescribing drugs to take home:
In line with national guidance, if simple over the counter drugs are required and it is appropriate, encourage the patient to self-medicate. Examples of this may be laxatives, simple analgesia, antihistamines etc. This is often cheaper for the patient compared to the NHS prescription charge of £8.60 per item (ie paracetamol and ibuprofen on prescription costs £17.20 compared to less than a pound from a supermarket). Clearly there will also be times where it is entirely appropriate to prescribe such drugs, eg an elderly patient requiring medicines who cannot get to a pharmacy and does not pay for prescriptions.
Some useful information:
1. We stock a number of drugs (analgesia and antibiotics) to take home in prepacks in the Treatment Room. In hours or for patients who can get to a pharmacy themselves please do not issue these - rather given an FP10. These medication have a label on them that must be filled in for the patient. Note any TTAs given on the log next to the drug cupboard. Unless patients are exempt (see back of FP10 for exemptions if unsure) they will need to pay for any medication issued by the ED with a card or contactless payment method at the reception/front desk. If they do not have a means of payment you need to issue them with the top copy of the medication payment information which they can then pay online at home.
2. Prescriptions to be collected from pharmacies are made on FP10 prescriptions. We can only prescribe up to 7 days worth of drugs. These must be collected from a pharmacy outside the hospital. Any ongoing medication should be sought from the GP. If you prescribe on an FP10 (kept in the CD cupboard in the treatment room), you MUST log it in the book the FP10s are kept in: patient sticker, what is prescribed and your name/GMC number or stamp.
3. Do not prescribe Tramadol. This is a consultant only prescription.
4. Patients seeking “forgotten medication” should be directed to a local GP or pharmacy unless it is a medicine that needs to be urgently given (eg an asthmatic who needs salbutamol is appropriate), however a holiday maker who has forgotten their Simvastatin should be directed elsewhere.
5. Do not prescribe large doses of oral morphine, diazepam etc. If you think this is appropriate, please discuss with a senior first. Some patients have drug seeking habits.
6. Do not prescribe soluble prednisolone. This is exceptionally expensive. Normal prednisolone tablets will dissolve in small volumes of water very well.