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Understanding Prescriptions in the UK

Gwyn Williams
Sep 27, 2021 7:00:00 PM

In the United Kingdom, there are several categories of medication available; prescription-only medicines (POM), pharmacy-only medicines (P) and General Sales List medicines (GSL). There are significant yet nuanced differences between each category and in this blog, MedAdvisor will walk you through each of those and how you can best navigate the various available prescriptions.

Prescription-only medicine (POM)

Prescription-only medications are medications that can only be prescribed by appropriate practitioners, including doctors, dentists and pharmacist independent prescribers. In specific circumstances a pharmacist at a registered pharmacy can supply medication to an individual in an emergency situation.

Pharmacy-only medicine (P)

The other form of medication is called “over-the-counter” medication under which both pharmacy-only and general sales list medicines can fall under.

Pharmacy-only medicine is a medicinal product that can only be supplied from registered pharmacy premises by a pharmacist or a person acting under the supervision of a pharmacist. Pharmacy medicines aren’t accessible to the public by self-selection.

General sales list medicines (GSL)

General sales list medicines are medications that are readily available at pharmacies as well as from supermarkets and can be sold without the supervision of a health professional.

A difference between these two different types of over-the-counter medication is that there are some remedies, such as some cough syrups, that can be easily purchased from the shelves of pharmacies. On the other hand, some medicines require pharmacist supervision, but not a prescription, including emergency contraception.

All health professionals that can prescribe medications are required to have completed an accredited prescribing course. Also, it is important to note that regardless of what category the medication falls under, the health professional has the power to refuse to supply medication to an individual and this is determined on a case-by-case basis.

The category names can also be slightly misleading as some medications that fall under both the pharmacy-only and general sales list medicines can be prescribed on a prescription. Some medicines can also be classified under more than one category depending on factors, such as formulation, strength and quantity.

Ultimately, the best way to get the clarity you need to see what medication is right for you is to speak to a healthcare professional, such as a pharmacist. And, once you do find the medications that are right for you, you can properly manage them through MedAdvisor, seamlessly integrating your medication schedule into your day-to-day life.

Why is prescription medicine important?

Prescription medicine saves and improves the lives of many every year. With one-quarter of the population having a long-term condition, according to the NHS, these individuals need to be provided with the right prescription medicine at the time needed.

For example, according to the comprehensive Health Survey for England, half of the women and over 40% of men in England are now regularly taking prescription drugs. With cardiovascular disease, high blood pressure and high cholesterol being some of the most common long-term conditions in the UK, prescription medicines help manage these, as well as many other conditions. 

Nearly a third of prescriptions in the survey were for cardiovascular disease with more than 65 million prescriptions for tackling high blood pressure, heart failure or high cholesterol levels.
Simvastatin – which lowers cholesterol – was the single most prescribed item with 40 million prescriptions.

It is also important that the right people, only those have been prescribed the item, receive the prescription medication. When appropriate, medication can help control long-term conditions (for example asthma) as well as treat temporary conditions (such as a bacterial infection) to improve overall health.

Prescription types 

There are several types of prescriptions, the most common being NHS GP prescribed repeat prescriptions.

As well as NHS GP prescriptions there are also other types of prescriptions, including private GP prescriptions, hospital outpatient prescriptions, dental prescriptions and nurse prescriptions.

Hospital outpatient prescriptions, for example, are different from the prescriptions given to you by your NHS GP and cannot be taken to any other pharmacy because they won’t be able to dispense it. Instead, it needs to be taken to the hospital outpatient pharmacy. 

When it comes to dental prescriptions, they can only be prescribed by dentists to diagnose, treat or prevent conditions of the oral-facial area of the patient they are treating.

There are many useful tools such as the MedAdvisor app to make the process of managing prescriptions easier. 

Electronic prescriptions in England

The NHS first introduced an electronic prescription service (EPS) in England over 10 years ago, allowing prescriptions to be signed by a doctor, sent and processed electronically. This is a more convenient and efficient way for prescriptions to be issued and dispensed in a pharmacy.

Prescriptions can be sent to the patient’s chosen pharmacy or Dispensing Appliance Contractor, otherwise referred to as a "nominated" dispenser. Paper prescriptions are still issued, however, their use is declining in England.

In the situation that a patient does not have an EPS nomination, they are provided with a token, which contains a unique barcode and can also be thought of as a paper copy of their prescription. This token can then be taken to any registered pharmacy for the patient to pick up their medication, or if the prescribed item is an appliance (such as a stoma bag) it can be sent to a Dispensing Appliance Contractor (DAC). Once the dispenser receives the token, the barcode will be scanned and the prescription form will be downloaded directly from the NHS Spine, which will provide the dispenser the necessary details of the patient’s medication.

It is important to ensure, however, that your pharmacy is legitimate, which you can check on the General Pharmaceutical Council (GPhC) website.

Repeat prescriptions

A repeat prescription is when a health professional prescribes the same medication on an ongoing basis and is often for a long-term or chronic condition.

Usually, the prescriptions will need to be dispensed regularly, and the medicine is often taken each day. The patient may only have a certain amount of repeats available before having to see their doctor for a follow-up consultation to keep getting their prescription issued. 

There are two distinct types of repeat prescriptions. Firstly, the most common type is where a patient is able to ask the GP surgery for a defined number of new repeat prescriptions to be issued before they need to be seen by their GP to be reviewed. They will need to ask the GP surgery for a new prescription to be written each time they need more medication. 

Secondly, electronic repeat dispensing prescriptions, or otherwise known as eRD, are issued when the doctor issues a patient a specific number of repeat prescriptions electronically via the electronic prescription service (EPS) so that they are readily available for the pharmacy to dispense to the patient every month, rather than the patient requesting a prescription from the GP surgery each time. This is because the prescription is already available at the pharmacy.

Repeat prescriptions are only provided when doctors are OK with you taking the medication consistently without regular checkups and therefore, typically happens after you’ve been on a specific medication long enough and the side effects and reactions you have to the medication are understood. For example, it is quite normal for individuals battling depression to explore several antidepressants to help minimise their symptoms before settling on one consistent long-term solution.

All of this information may seem overwhelming to keep up with, so it is important to use daily reminders and scheduling through smartphone applications, like MedAdvisor. For those that are on a repeat prescription, several apps exist on the market, which allow people to order repeat medication electronically. 

Prescription charges

Prescription charges vary depending on where you’re located within the UK. In England, since 1st April 2021, the price of each prescription item is £9.35. The NHS website provides information on prescription charges. Prepayment certificates are a great way for those who pay for their prescriptions and are on multiple medications to save money.

Defined groups of individuals and people with certain medical conditions are eligible for free prescriptions. Some groups are immediately entitled to free prescriptions, for example, individuals over the age of 60 or under the age of 16. However, other groups require certificates to entitle them to a free prescription. This includes pregnant women or those who have had a baby in the last 12 months.

Some prescription medications are always free, such as contraceptives. However, be sure to always check whether you’re eligible. If you wrongly claim a free prescription that you’re not entitled to, you may be fined.

If you live in Wales, Scotland or Northern Ireland you don't have to pay for your prescriptions.

Managing Your Prescriptions

Managing prescriptions can often be difficult, especially if you are balancing several prescription medications. Remembering to take it correctly (for example with or after food, or in the morning), is often the reason that people can’t properly adhere to their medication schedule.

While not sticking to your medication schedule could mean that it takes longer for you to get better, sometimes, not taking it correctly could have more harmful consequences. Multiple studies show that not adhering to medications can lead to patients getting sicker, leading to higher healthcare costs. 

Several MedAdvisor app users reported relying on memory and routine habit associations. ​​Jenny B recently told us that she takes most of her medication in the morning so she takes them before she cleans her teeth whilst Barbara B takes her medication as soon as she eats breakfast.

However people choose to remember, it is imperative that those managing prescription medications organise their routine in a way that works for them. Luckily, there are several medication management apps and platforms available to help people remember to take their medication as prescribed.

MedAdvisor Medication Management App

When it comes to managing medication, the MedAdvisor app is a popular choice. 

With many great features such as medication supply tracking, automated reminders, notifications to collect medication and prescription ordering available 24/7, the app is a perfect solution for anyone looking to get on top of their medication schedule amid their busy lives.

According to Harrison F, who uses the MedAdvisor app on Apple, “Considering everything that is happening in the current medical climate of the world, this app has been phenomenal. I highly recommend to anyone that takes medication to use this app as it allows you to live your life without the stress of missing medication times...”

This is further echoed by another app user, Lynn, who takes 18 prescription medications for long-term conditions. “Without this app, I struggled to remember what meds I was on. This app does it all and more.”

Key messages

In England, 50% of the population takes prescribed medication every day and 26 million people in the country live with a long-term condition, with prescription medications costing the NHS over £15 billion a year. However, research indicates that 33% of patients do not adhere to their medications with the noncompliance estimated to cost the NHS around £500 million per year.

Not adhering to your prescription medications could mean you don't get the best treatment to manage your conditions, as well as resulting in increased costs for the NHS. With MedAdvisor and other medication management apps widely available, getting on top of your medication schedule has never been easier.

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