GPs concerned about transfer of prescriptions from ‘self-referral’ services

Concerns have been expressed by GPs in regard to transferring prescriptions from private self-referral and virtual providers onto a GMS prescription. 

Self-referral services are private services which do not require GP referral. Such services may offer GP consultations, as well as psychiatry and attention deficit hyperactivity disorder assessments. 

A patient who accesses such services may wish to have a prescription filled under their medical card, in which case the prescription would need to be transposed to their own GP. 

Louth GP Dr Amy Morgan told the Medical Independent: “When our name goes on it [the prescriptions] we’re ultimately responsible for it and its monitoring and its surveillance.” 

“I am just wary that, potentially, follow-up and error has been transposed onto the GP, who is not being adequately communicated [with], potentially exposing patients to risk,” she said. 

GPs may not be comfortable prescribing the medication and have no communication channel with the original prescriber, she noted. 

In Dr Morgan’s experience, communications from self-referral services usually involve “requests to perform physical tests on the patients”. In addition, she said the patient/pharmacy may contact the GP to transpose a prescription onto the GMS scheme. 

Dr Morgan is seeing these requests with increasing frequency. “I think the Medical Council need to be aware that this is not just an isolated instance.” 

According to the Medical Council, its Guide to Professional Conduct and Ethics for Registered Medical Professionals (Amended) 8th Edition has “several paragraphs” pertaining to this area. 

“If, for example, a service is referring a patient back to their GP, then they should be guided by paragraph 22, on delegation and referral.” 

The spokesperson referred to other paragraphs within the guide that may be consulted, such as paragraph 36 (continuity of care) and paragraph 38 (referral of patients). 

The guide also states that “as far as possible, you should make sure that any treatment, medication or therapy prescribed for a patient is safe, evidence-based and in the patient’s best interests”. 

In 2019, the Council published a guidance document on telephone and video consultations. 

“If anyone has any concerns about a doctor providing a telemedicine service, they can contact the Medical Council,” the spokesperson added. “The Medical Council can only act where complaints are of a serious nature and raise concerns over a doctor’s fitness to practise.”