Locally the hospital removes all prescribing pads from clinics without consultation with primary care. In Suffolk, like most areas, we have guidance from our drug and therapeutics committee on initiation of new medication using a traffic-light system.
This divides drugs up into hospital only; hospital-initiated and stabilised, with GPs continuing; or hospital advice, initiated in the community.
The drugs are allocated after careful consideration, normally for reasons of safety or complex initiation. I have often been asked to issue drugs that are not licensed and even not in the BNF.
We receive poor written requests to initiate medicine, with no indication of reasoning or indication of use. Sometimes I think hospital doctors fail to understand that responsibility for a prescription lies with the doctor signing the script.
When they ask me to issue something I do not recognise and offer no other information, I will play safe and reject the request, in the patient’s best interest, for safety reasons.
Dr Ben Solway