The scene

A hospital consultant spoke to the MDU after receiving a letter from the GMC. The letter explained that a pharmacy had raised a concern about the doctor having written several private prescriptions for a patient with the same last name as the doctor, and apparently living at the same address.

The consultant sent a copy of the letter to the MDU. The MDU adviser explained the GMC correspondence meant that they had decided to formally investigate the complaint.

Explaining the GMC investigation process to the consultant, the adviser said that the GMC had invited him to make comments at this stage but that he was not obliged to do so, and there would be an opportunity to respond to clear allegations from the GMC at a later stage. She explained that whether or not to respond at this stage was something which had to be carefully considered as while a well-considered response might be helpful, some responses might be unhelpful or inadvertently result in a widening of the concerns the GMC wished to address.

The hospital consultant explained that his mother had recently moved in with him as she had become increasingly frail and slightly forgetful. She had also been diagnosed with hypertension and had previously been prescribed treatment. Unfortunately, she had run out of her medication just before a bank holiday weekend, and as he felt that this was urgent he had written a private prescription. At the end of that prescription, however, his mother asked him to continue to prescribe the medication, as she did not wish to contact a GP, and so he had written a second prescription.

MDU advice

The MDU adviser discussed the GMC guidance in paragraph 67 of Prescribing and managing medicines and devices. This explains that wherever possible, doctors must avoid prescribing for anyone with whom they have a close personal relationship.

The GMC sets more stringent guidelines for controlled medicines, which doctors can only prescribe to someone close to them if there is no-one else available who is able to do so and the treatment is immediately necessary. If a doctor does need to prescribe anything for themselves or someone close to them, they must make a clear record of why it was necessary to prescribe and, with the patient's consent, tell the patient's own doctors what happened.

The consultant and the adviser agreed that it was important for both patient and doctor that there was a clear separation of the personal and professional relationships. The consultant understood that a GP would be better placed to follow the NICE guidelines for treating hypertension and would need to arrange the monitoring required for patients on ACE inhibitors. The GP would also have the full past medical records.

They also discussed the benefits to his mother to have an impartial doctor, with a duty of confidentiality to her and in whom she could confide. They discussed the emotional pressure to help his mother he had felt as a son, how this had encouraged him to act outside his usual practice, and why this was therefore a good reason not to be involved in his mother's medical care.

Having discussed the member's reflections on the events, the adviser suggested it might be beneficial to provide early comments to the GMC to evidence this insight and reflection. With MDU assistance, the member was able to write a letter explaining what had happened and providing personal reflection, assuring the GMC he had remediated. As a result, the GMC closed the investigation without further action.

While the GMC investigation was stressful and difficult for the member, with advice and assistance from the MDU, the member was able to navigate the process. He felt that having discussed the ethical dilemma with an adviser it would help him manage better if similar requests came from family members in the future.

GMC investigation over prescribing concerns

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