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Prescribing by dental
surgeons
Until
new pre-
scribing arrangements are in place for NHS prescrip-
tions, dental surgeons should use form FP10D (GP14 in
Scotland,
WP10D in Wales)
to prescribe only those
items
listed in the
Dental
Practitioners’
Formulary.
The Act
and Regulations do not
set
any limitations
upon the number and variety of
substances which the
dental surgeon may administer to patients in the surgery
or
may order
by private prescription—provided the
relevant
legal
requirements
are observed the dental
surgeon may use or order whatever is required for the
clinical situation.
There is no statutory requirement for
the dental
surgeon to communicate with a patient’s
medical
practitioner
when prescribing for dental
use.
There are, however, occasions when this would be in the
patient’s
interest
and such communication is
to be
encouraged. For legal requirements relating to prescrip-
tions for Controlled Drugs,
see p.
8.
Computer-issued prescriptions
For computer-issued prescriptions the following advice,
based on the recommendations of
the Joint GP Infor-
mation Technology Committee,
should also be noted:
1.
The computer must print out the date, the patient’s
surname,
one forename, other initials, and address,
and may also print out the patient’s title and date of
birth.
The age of
children under 12 years and of
adults over 60 years must
be printed in the box
available;
the age of children under 5 years should
be printed in years and months. A facility may also
exist to print out the age of patients between 12 and
60 years.
2.
The doctor’s name must be printed at the bottom of
the prescription form;
this will
be the name of the
doctor
responsible for
the prescription (who will
normally sign it).
The doctor’s
surgery address,
reference number,
and Primary Care Trust (PCT
1
)
are also necessary.
In addition,
the surgery tele-
phone number should be printed.
3.
When prescriptions are to be signed by general
practitioner registrars,
assistants,
locums,
or depu-
tising doctors, the name of the doctor printed at the
bottom of the form must still be that of the respon-
sible principal.
4.
Names of medicines must come from a dictionary
held in the computer memory,
to provide a check
on the spelling and to ensure that
the name is
written in full.
The computer can be programmed
to recognise both the non-proprietary and the pro-
prietary name of a particular drug and to print out
the preferred choice,
but
must
not
print
out
both
names. For medicines not in the dictionary, separate
checks are required—the user must be warned that
no check was possible and the entire prescription
must be entered in the lexicon.
5.
The dictionary may contain information on the
usual
doses,
formulations,
and pack sizes to pro-
duce
standard
predetermined
prescriptions
for
common preparations,
and to provide a check on
the validity of an individual prescription on entry.
6.
The prescription must be printed in English without
abbreviation; information may be entered or stored
in abbreviated form. The dose must be in numbers,
the frequency in words, and the quantity in numbers
in brackets,
thus:
40 mg four times daily (112).
It
must also be possible to prescribe by indicating the
length of treatment required,
see (h) above.
7.
The BNF recommendations should be followed as
in (a), (b),
(c),
(d),
and (e) above.
8.
Checks may be incorporated to ensure that all
the
information required for
dispensing a particular
drug has been filled in.
For
instructions such as
‘as directed’
and ‘when required’,
the maximum
daily dose should normally be specified.
9.
Numbers and codes used in the system for organis-
ing and retrieving data must never appear on the
form.
10.
Supplementary warnings or advice should be writ-
ten in full, should not interfere with the clarity of the
prescription itself,
and should be in line with any
warnings or
advice in the BNF;
numerical
codes
should not be used.
11.
A mechanism (such as printing a series of
non-
specific characters) should be incorporated to can-
cel out unused space, or wording such as ‘no more
items on this prescription’
may be added after the
last
item.
Otherwise the doctor should delete the
space manually.
12.
To avoid forgery the computer
may print
on the
form the number of
items to be dispensed (some-
where separate from the box for the pharmacist).
The number of items per form need be limited only
by the ability of
the printer to produce clear and
well-demarcated instructions with sufficient space
for each item and a spacer line before each fresh
item.
13.
Handwritten alterations should only be made in
exceptional
circumstances—it
is
preferable
to
print out a new prescription.
Any alterations must
be made in the doctor’s own handwriting and coun-
tersigned;
computer records should be updated to
fully reflect any alteration.
Prescriptions for drugs
used for contraceptive purposes (but which are not
promoted
as
contraceptives)
may
need
to
be
marked in handwriting
with the
symbol
, (or
endorsed in another way to indicate that the item
is prescribed for contraceptive purposes).
14.
Prescriptions for controlled drugs can be printed
from the computer,
but
the prescriber’s signature
must be handwritten
2
.
15.
The strip of paper on the side of the FP10SS
3
may
be used for
various purposes but
care should be
taken to avoid including confidential information. It
may be advisable for the patient’s name to appear at
the top,
but this should be preceded by ‘confiden-
tial’.
16.
In rural
dispensing practices prescription requests
(or details of medicines dispensed) will normally be
entered in one surgery.
The prescriptions (or dis-
pensed medicines) may then need to be delivered to
another surgery or location;
if possible the compu-
ter should hold up to 10 alternatives.
17.
Prescription forms that are reprinted or issued as a
duplicate should be labelled clearly as such.
1.
Health Board in Scotland,
Local
Health Board in Wales.
2.
See Controlled Drugs
and Drug Dependence p.
8;
the
prescriber may use a date stamp.
3.
GP10SS in Scotland,
WP10SS in Wales.
6
Prescription writing
BNF 61
Prescription writing