Prescriptions from an approved healthcare professional and country

Prescriptions and repeatable prescriptions issued by an approved health professional registered in an approved country are legally acceptable in the UK.

If the prescription originates from a country or prescriber not on the approved list, the prescription is not valid and you should use your professional judgement in finding the best way to help the patient.

List of approved health professionals

• Doctors
• Dentists
• Prescribing chiropodists
• Prescribing podiatrists
• Prescribing nurses
• Prescribing optometrists
• Prescribing paramedics
• Prescribing pharmacists
• Prescribing physiotherapists
• Prescribing therapeutic radiographers

List of approved countries (includes EEA countries and Switzerland) 

• Austria
• Belgium
• Bulgaria
• Croatia
• Cyprus
• Czech Republic
• Denmark
• Estonia
• Finland
• France
• Germany
• Greece
• Hungary
• Iceland
• Ireland
• Italy
• Latvia
• Liechtenstein
• Lithuania
• Luxembourg
• Malta
• Netherlands
• Norway
• Poland
• Portugal
• Romania
• Spain
• Slovak Republic
• Slovenia
• Sweden
• Switzerland

Checking registration status of the approved healthcare professional

It may not always be possible to check the registration of a prescriber. An international database of prescribers does not exist, and not all of the approved countries have a register of practitioners or online registers in English.

EEA competent authorities

To check registration details of doctors and dentists, up-to-date contact details for EEA-competent authorities may be found on the following websites:

• Doctors – General Medical Council
• Dentists – General Dental Council.

The European Commission has a database where you can search regulated professions and competent authorities in the approved countries.

Practical tips

If you’re doubtful of a prescription’s authenticity or prescriber registration, you could try to contact the prescriber by:

• Checking the prescription for prescriber contact details and registration.
• Checking the clinic website for contact details and registration.
• Speaking to the person needing the medicine for contact details for the prescriber or clinic.
• Checking prescriber details through the General Medical Council (GMC) or equivalent organisation (see above).

If you cannot confirm registration status

If it is not possible to confirm the registration status of the prescriber after taking all reasonable steps to do so, then it may still be possible to make a safe and legal supply in the interests of patient care.

It would be beneficial to keep a record of the details of any interventions and steps taken. This would require checking and being satisfied that prescription requirements are fulfilled, questioning the patient, and careful use of professional judgement.

Prescription requirements

The following details are required on a prescription from an approved HCP registered in an approved country to be legally valid:

• Patient details – patient’s full first name(s), surname and date of birth.
• Prescriber details – prescriber’s full first name(s), surname, professional qualifications, direct contact details including email address and telephone or fax number (with international prefix) and work address (including the country they work in) – also see the section on checking registration.
• Prescribed medicine(s) details – name of medicine (brand name where appropriate), pharmaceutical form, quantity, strength and dosage details:
  • Only products with a marketing authorisation valid in the UK can be prescribed or supplied.
  • Schedule 1, 2 and 3 controlled drugs (CDs) cannot be prescribed or supplied.
  • Medicines that have been prescribed off-label (i.e., using a licensed medicine outside of its approved use) can be prescribed or supplied.
  • Check if brand prescribing is appropriate, see the Specialist Pharmacy Service guide on prescribing by generic or brand name in primary care.
• Prescriber signature.
• Date of issue
  • Prescriptions from approved countries are valid for up to six months from the date on which the prescription was signed.
  • Prescriptions from approved countries for schedule 4 CDs are valid for 28 days from the date when the prescription was signed.
• Repeatable prescriptions
  • Repeatable prescriptions from approved countries can be repeated as indicated by the prescriber. If a number is not stated, they can only be repeated once (dispensed two times in total) unless the prescription is for an oral contraceptive in which case it can be repeated five times (dispensed six times in total).
  • While there is no time limit for remaining repeats, pharmacists should use professional judgement, taking into consideration clinical factors, to determine whether further repeat dispensing is appropriate.

Even if the prescription requirements have been written in a foreign language the prescription is still legally acceptable. However, the pharmacist needs to have enough information to enable the safe supply of medicines considering patient care and wellbeing – see our pharmacy guide on professional judgement.

Clinical checks

You should also be satisfied the prescription is clinically suitable for the person requesting including dose, age, contraindications and cautions. Use our clinical checks pharmacy guide for further help with this. 

Other considerations include:

• Monitoring – are there any monitoring requirements for the medicine the person is using? How will they access this and how often?
• Follow up – does the person know who is responsible for their care and follow up and how they can access this?

Counselling 

Advise the person to read the patient information leaflet and packaging – as a reminder of key safety messages.

Discuss the following:

• The medicine – what it is, how it works, how to use (including the importance of adherence).
• Side/adverse effects and risks – make sure the person is aware what signs and symptoms to look out for, how to manage them and when to seek medical attention and advice.
• Further supplies – the person is aware how to obtain further supplies.
• Interactions – the person is aware to check interactions with a pharmacist before starting any new medicines.
• Referrals – the person is aware of when to see a prescriber.

For further information on counselling and when to refer, see the BNF and relevant product SPC. You may also find our pharmacy guide on counselling people on the use of medicines useful.

Other considerations:

• Record keeping – see our guide on clinical documentation.
• Online purchases – highlight the risks of purchasing medicines online. If buying from unregulated sources, the medicines may not have been tested for safety or effectiveness. Advise the person to check that the medicine is being supplied from a reputable provider before purchasing – see guidance from the GPhC on providing services online.
• Disposal – advise the person to return any unused medicines to a pharmacy for disposal.
• Signposting – does the person need to access reliable information?

Emergency supply

Emergency supplies for patients of approved HCPs registered in an approved country are also legally possible at the request of the patient or prescriber.

• The usual emergency supply process should be used and where the supply originates from a prescriber then the prescription needs to be received within 72 hours
• Remember, medicinal products without a marketing authorisation valid in the UK and schedule 1, 2 and 3 CDs cannot be supplied or prescribed on a prescription by an approved HCP from an approved country.

If the emergency supply is not for a patient of an approved HCP registered in an approved country at the request of the patient or prescriber, then you cannot provide an emergency supply. You should use your professional judgement in finding the best way to help the patient.

For further information, see our pharmacy guide on dealing with emergency supplies.

When to refer

It is important to bear in mind that the legislation is enabling – it is not obligatory to dispense a prescription from an approved country if presented with one.

You should use your professional judgement when handling prescriptions or emergency supply requests from approved HCPs from approved countries. Follow existing guidelines and local standard operating procedures.

You may feel a referral to a prescriber based in the UK would be appropriate if:

• You are not satisfied the prescription is clinically appropriate.
• You are not satisfied the prescription is legally valid or genuine.
• An emergency supply is not appropriate.
• The item on prescription or emergency supply request is for a schedule 1, 2 or 3 CD.
• The item on the prescription or emergency supply request is for a product without a marketing authorisation valid in the UK.

Pharmacists are empowered to refuse to sell or supply ANY medicines if the sale or supply is contrary to the pharmacist’s clinical judgement. You should take each situation on a case-by-case basis.

It would be beneficial to keep a record of the details of any interventions, steps taken and  your reasoning – for further information see our clinical documentation guide. 

Communication is key

Good communication between the pharmacy team and the person needing medicines is key, remember:

• Take a person-centred approach.
• Be non-judgemental, compassionate, empathetic, respectful of confidentiality and actively listen so the person feels confident in you to discuss their concerns and expectations.
• If there is an issue/concern with the prescription and the person needing the medicine or representative is waiting, keep them informed of the situation.
• If the person isn’t present, contact them to keep them informed of the situation and if needed find out any relevant information.

Good communication between the pharmacy team and the prescriber is also key:

• Interact and communicate with other healthcare professionals in a collaborative and professional way – document issues/concerns and discussions with prescribers.