Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Guiding principles for prescribing "Specials"

The National Prescribing Centre has published "Prescribing Specials – Five guiding principles for prescribers" (PDF). This resource discusses the prescribing of special-order unlicensed medicines (or Specials) made to meet the needs of an individual patient.

Prescribing Specials is associated with more risk than when prescribing a licensed medication. This document introduces five principles to support prescribers in the safe and appropriate use of Specials. The five principles are:

  • Establish a clinical need - Can the clinical need of the patient only be met by a Special?
  • Identify medicines and preparations - Consider the safety, effectiveness, quality and cost of all the options available
  • Make a shared decision with the patient (or carer)
  • Ensure effective prescribing governance - Understand the rationale for using a Special and the practical implications before prescribing
  • Monitor and review on an ongoing basis - the need for the Special should be regularly reviewed in terms of the Special and the medicine it contains

Action: This document is a valuable resource to any clinician who may need to prescribe a Special product.

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