Prescribing for Secondary Care

When you visit the hospital for an appointment or for treatment, you may be recommended a medication to take by your specialist. The specialist will then instruct your GP surgery either via phone or letter to prescribe this medication going forward.

Instructions from the hospital can sometimes be delivered the same day to the GP however most come within two weeks.

Once the surgery receives the instruction, the drug is normally issued within a few days. The specialist should have counselled the patient regarding any side effects, monitoring required and interactions with their other drugs. They should also inform the patient the drug will normally automatically be issued to their normal chemist or the script to be collected if that is usual for the patient.

Patients should contact the surgery if the medication has not been issued within two weeks of their appointment. The usual reason for this will be that the letter hasn’t yet reached our surgery. The chemists are now able to dispense medication as soon as we issue it electronically thanks to EPS4, the NHS’s electronic prescribing service.


Prescriptions are sometimes not issued for the following reasons:

  • The patient notes indicate there is an allergy to the medication
  • The patient is already taking a similar medication so they would get a toxic dose
  • Monitoring of some kind is required before issue and the GP does not have the required information. The prescriber is responsible for any harm so we cannot issue anything if we do not think it safe
  • The drug is discontinued, not prescribable on the NHS, hospital only medication or not part of the CCG formulary
  • The drug is rare, the GP has never issued it before and doesn’t feel competent to do so

These are unusual but do occur. We try to let patients know if we are not prescribing but the volume of requests is so great we cannot inform everyone when their script has been done. If you have any further questions regarding our prescribing policy for secondary care, please get in touch with us.

Hospital Prescriptions

These prescriptions must be dispensed at the hospital pharmacy. This information is stated clearly on the prescription issued by the hospital.

The surgery is unable to change a hospital prescription to a FP10 as:

  • the hospital clinician has made the clinical diagnosis and prescribed accordingly, taking responsibility for the medication
  • your GP has not been involved in this process and it is therefore inappropriate for them to take over this responsibility