Purpose of This Policy

This policy outlines how prescribing will be safely managed within Kerala Doctors UK once the service is operational. It ensures that all prescribing decisions are safe, appropriate, evidence-based, and compliant with professional and regulatory standards.

General Principles of Prescribing

All prescribing will be:

• Clinically appropriate for the patient
• Based on a thorough clinical assessment
• In line with GMC Good Medical Practice
• In accordance with NICE guidelines
• Supported by relevant clinical evidence
• Clearly documented in the patient record

Prescribing will always prioritise patient safety.

Remote Prescribing Principles

As a remote GP service, prescribing will only occur when:

• The clinician has sufficient clinical information to make a safe decision
• The patient’s identity has been verified
• The medication is appropriate for remote initiation
• The risks of remote prescribing have been considered
• The clinician is satisfied that a face-to-face assessment is not required

Where remote prescribing is not appropriate, patients will be advised to seek in-person assessment.

Medications We May Prescribe

Subject to clinical judgement, we may prescribe medications commonly used in primary care, including:

• Antibiotics for confirmed or likely infections
• Medications for allergies
• Asthma and respiratory medications
• Skin condition treatments
• Gastrointestinal medications
• Hypertension and cardiovascular medications (where stable and appropriate)
• Mental health medications (where clinically appropriate and safe)
• Short-term symptomatic relief medications

All prescribing will be within the competence and scope of GMC-registered GPs.

Medications We Do Not Routinely Prescribe

To ensure patient safety, we will not routinely prescribe:

• Controlled drugs (unless exceptional clinical circumstances apply and governance allows)
• High-risk addictive medications without prior medical records
• Medications requiring specialist monitoring without shared care arrangements
• Drugs for cosmetic or non-medical enhancement purposes
• Treatments that require physical examination where remote assessment is insufficient

Clinical judgement will always apply, and exceptions may be made only where safe and appropriate.

Repeat Prescriptions

Repeat prescriptions may be issued only when:

• There is clear evidence of previous prescribing history
• The condition is stable
• Clinical review supports continuation
• Appropriate monitoring is in place where required

We may request external medical records before continuing long-term medication.

Prescription Safety Checks

Before issuing any prescription, clinicians will consider:

• Patient identity verification
• Allergies and contraindications
• Drug interactions
• Dosage appropriateness
• Previous medical history
• Current symptoms and clinical presentation

Pharmacy and Dispensing

Prescriptions will be issued electronically and sent to a patient’s chosen pharmacy where possible.

Patients will be responsible for collecting medication unless alternative arrangements are clinically required.

Prescribing for Vulnerable Patients

Additional safeguards will apply when prescribing for:

• Children and young people
• Elderly patients
• Patients with mental health conditions
• Patients with learning disabilities
• Patients at risk of medication misuse

Enhanced clinical caution and safeguarding considerations will apply.

Clinical Responsibility

All prescribing decisions will be made by GMC-registered clinicians who take full professional responsibility for their prescribing decisions.

Governance and Oversight

Prescribing practices will be overseen by:

Nominated Individual

Dr S Alex Thachankary (GMC 4750323)

Registered Manager

Siby Sebastian (subject to CQC approval)

Regular audits, reviews, and clinical governance checks will be implemented once the service is operational.

Compliance

This policy will comply with:

• General Medical Council (GMC) guidance on prescribing
• NICE clinical guidelines
• Medicines and Healthcare products Regulatory Agency (MHRA) guidance
• Care Quality Commission (CQC) requirements
• UK GDPR and data protection laws

Policy Review

This policy will be reviewed regularly and updated as required to reflect changes in legislation, clinical guidance, or service development.