Non medical prescribing in Scotland: implementation guide

Appendix 5: How to complete the prescription form

1. Detailed advice on prescription writing is contained in the British National Formulary ( BNF).

2. The nurse prescriber should complete all the details on the front of the prescription form by writing clearly and legibly using an indelible pen (preferably black). The details required are:

• the patient's title, forename, surname and address (including postcode)
• age - N.B. it is a legal requirement to write the patient's age on the prescription when prescribing prescription only medicines for a child under 12 years of age
• CHI number, when possible
• nurse prescribers should use the product description as listed in the BNF
• for prescribing in primary care, the prescription should contain the name of the prescribed item, formulation, strength (if any) dosage and frequency, and quantity to be dispensed. The quantity prescribed should be appropriate to the patient's treatment needs, bearing in mind the need to avoid waste. Some medicines are only available in patient packs (or multiples thereof) ⁴⁵⁴⁶ and special containers ⁴⁷ and the quantity contained should be prescribed, provided this is clinically and economically appropriate. The quantity should be specified for solid preparations as number of dose-units (number of tablets, capsules, lozenges, patches, etc.), for liquid measures in millilitres (mL or ml), for topical preparations by mass (grams, g) or volume (millilitres, ml). Terms such as '1 Pack' or '1 OP' should not be used. Alternatively, for preparations to be given at a fixed dose and interval, the duration(s) of treatment can be given in place of quantity to be dispensed. Current best practice requires quantity to be clear on the prescription form.
• in hospitals, prescriptions for in-patients should contain the name of the prescribed item, formulation, strength (if any), dosage and frequency. Where a defined length of treatment is required this should be stated. For outpatients and discharge prescriptions, the requirements are the same as those for primary/community care, whilst recognising local policies for example on the length of treatment provided for outpatients and patients who were being discharged
• the names of medicines should be written clearly using approved generic titles (where available) as specified throughout the BNF and should not be abbreviated. The only exception to this rule is for the prescribing of some dressings and appliances, and of compound or modified release medicines which have no approved non-proprietary name
• directions, if for use or application by the patient or carer, which should be in English and not abbreviated
• where there is more than one item on a form, a line should be inserted between each item for clarity
• unused space in the prescription area of the form should be blocked out with, for example, a diagonal line (to prevent subsequent fraudulent addition of extra items)
• prescriber's signature and date
• nurses should ensure the appropriate prescriber code is entered on the prescription form if this has not been pre-printed.

3. Nurses will need to ensure that the prescription is cost-effective and meets the clinical needs of the patient. Local formularies may help here. Patients requiring long-term treatments should have their clinical management and medical product needs regularly assessed and prescriptions issued should reflect assessed need. For patients with enduring conditions that require continuing medication, dressings or appliances, nurses will need to balance patient convenience with the need to avoid waste of NHS resources and of excessive quantities of medicines in the patient's home. Only sufficient supplies should be prescribed to enable the fulfilment of the care plan, normally up to the re-evaluation date. Current best practice indicates that regular prescriptions should be issued for up to 28 days.

4. Items that require a doctor's signature should not be entered on a nurse prescription even if the doctor countersigns them. A GP prescription must be used at all times when the GP's signature is required.