Prescriptions

Prescriptions from face-to-face appointments

When we write a prescription during a face-to-face appointment, we usually give you the paper prescription for you to take directly to the community pharmacy.

Repeat prescription requests

When you request your repeat prescription, we let your nominated local pharmacy pick up the paper prescription from us at the surgery. Time is taken for the prescription to be prepared at the surgery, picked up by the pharmacy and processed by the pharmacy.

Prescriptions after you see a specialist

When a specialist, for example a hospital doctor, writes you a prescription, they will usually tell you where to take your prescription (for example, the hospital pharmacy or the community pharmacy).

Sometimes, specialists recommend a medication but consider that it would be more appropriate for the GP to actually write the prescription. They may therefore write to us with a recommendation or ask you to pass on their recommendation to us. There is no guarantee that we are able to accept their recommendation.

You are welcome to book an appointment to discuss review of your medication.

Some repeat prescriptions require review from time to time.

If you already have a medical plan which includes reviews or checks in relation to your medication, then please be organised with arranging your review appointments to support uninterrupted prescribing.

When we notice that your treatment would benefit from a medication review, we commonly leave a message on the counterfoil of your paper prescription, or we might send you a text message. We might also leave a "review date" on your prescription so you know when, at the latest, to book your review appointment.

Some commonly prescribed medications have standard review schedules for patients who are not having problems with their medication:

• antidepressants and anxiety medications: mental health nurse or GP appointment on the agreed review date

• asthma and COPD inhalers: at annual health check with the practice nurse (you will be invited)

• blood pressure medicines: once on a stable dose, review at annual health check with the practice nurse (you will be invited)

• contraception: three month check after starting then annual review with the practice nurse

• HRT: three month check after starting then annual review with the GP or advanced nurse practitioner

• hypothyroidism (levothyroxine): once on a stable dose, review by an annual blood test (phlebotomist appointment)

If you need a particular prescription-only medication which is not on your current repeat list but you think that we won't need you to consult us to write a prescription, you could make a special request. You can do this via the online system or by completing a paper request form at reception. Please include an explanatory note. We may accept your request and send a prescription to the pharmacy; decline it; write an alternative prescription; or respond at our discretion.

Don't make a special request if it is not in keeping with your existing medical plan - it would usually be better to book an appointment.

Going abroad

You can also make a special request for a longer-than-normal supply of your usual repeat medication if you are temporarily leaving the area. It is usually possible (in some, but not all, circumstances) to get a prescription for up to three months supply. If you need longer than a three months supply, NHS Scotland does not cover this, so your main options are to access healthcare in the area to which you are travelling or to ask us for a private prescription (for which there is a charge at the pharmacy). Prescriptions written to cover the possibility of a new illness arising while you are travelling are not provided on the NHS.

The local pharmacies keep stock of some of the most commonly prescribed medications. If the medication is not in stock at the pharmacy, they are usually able to order it in for you, causing a short delay to you getting your medication.

Sometimes the pharmacy cannot order in your medication due to a supply problem. This could be a problem affecting the pharmacy's own suppliers or it might be a nationwide problem - the pharmacist can normally advise.

If there is a supply problem, the pharmacy

1. will check with other local pharmacies and with other suppliers available to them. They might return your prescription to you for you to take to other pharmacies but it is usually preferable for them to check first in order to guide you.

2. might be able to give you a different form of the same medication eg a capsule instead of a tablet, a cream instead of an ointment. Sometimes the pharmacy needs to check with the prescriber or ask us for a new prescription.

3. failing the above, might contact us at the surgery. The pharmacist might suggest a suitable alternative medication to us. 

If the pharmacy ask you to contact us yourself, please give us details of what avenues have been explored already.

Some medications have suitable alternatives which we can prescribe without an appointment. Some medications have no direct replacement and some require an appointment to discuss your options.

What is a prescription

A prescription is an instruction to a pharmacist which authorises them to dispense a certain amount of a particular medication to you, along with instructions about how you should take the medication.

NHS prescriptions in Scotland are usually printed on a paper form which is then given to a pharmacy. Your list of medications which you have been prescribed at the surgery is stored in your electronic GP patient record.

NHS prescriptions in Scotland are usually written for the generic name of the active ingredient and not for any one particular brand. There is no charge for medications which are prescribed on the NHS.

Prescribers

Prescriptions can be written by doctors, nurse practitioners, prescribing pharmacists, some nurses who have a prescribing qualification and some allied health professionals who have a prescribing qualification.

Formulary medicines

NHS Scotland has special committees which advise prescribers on

• which medication(s) can be offered

• which particular version of that medication should be offered

• medications which can be prescribed but not on the NHS

• medical situations in which they should not offer a prescription

It is routine for GPs and other primary care prescribers to offer a different medication from the one which a patient has been recommended by another clinician or has been prescribed previously, in line with the national and local recommendations.

What is a repeat prescription

When your prescriber intends for you to have the option of continuing or repeating a medication, they will often write it into your list of repeat medications. Often this means that you can request a new prescription without needing a new appointment and simply by making a repeat prescription request. Your prescriber can give you guidance as to how they expect you to use the medication over time and whether it will require review. It is usual for your prescriber to set a limit on the number of times a repeat prescription can be issued before it requires a review; this will often depend on the type of medication.

One-off "acute" prescriptions

When your prescriber intends that your medication is a one-off prescription for short term use, they usually write an "acute" prescription - this means that there is no automatic possibility of the medication being repeated after the first supply runs out.

The chronic medication service is a special service which allows our patients to access enhanced advice and review of long-term medications directly with the pharmacist at their chosen community pharmacy. You need to register for this at the pharmacy.

As part of this service, the surgery supports "serial prescribing" for some long term medications. This means that we can instruct the pharmacy to dispense your medication for around a year without you needing a new prescription from the surgery each time you need more medication. The surgery still takes overall responsibility for your medical care and it doesn't affect your ability to contact us or make appointments.

You are welcome to ask us to consider putting your medications onto this system.

Sometimes we go ahead and transfer eligible prescriptions to this system when we are reviewing your medications, as it is usually highly convenient for patients. If we do this, we will leave a message for you, and you are welcome to cancel the service if it doesn't suit you.