Prescribing for ex-offenders

Prisons can get FP10 and FP10MDA prescription forms from their NHS England Area Team.

The prison will need to contact their Area Team and ask them to add each new prescriber to our database before ordering prescription forms.

If a prescriber already works in primary care, such as a GP practice, as well as providing medical services to a prison in the same Area Team, the prescriber will need to notify the Area Team separately for their prison-based service provision. This requirement includes prisons where Area Teams either provide or commission prison healthcare services.

Where prisons have locum prescribers, Area Teams will have to establish internal mechanisms for accessing FP10 / FP10MDA agreed with the controlled drug accountable officer.

Area Teams should send the details of each prison prescriber to us using the standard form. Existing prescribers will also require new prescriber codes and prescription forms to make sure that the costs are charged back to the correct Area Team budget.

Prescriptions must be stored safely and securely. Access to the prescriptions should be by named personnel only. Records should be kept of the serial numbers of prescriptions received and supplied to prescribers.

Standard operating procedures for the handling of prescriptions should be adapted by prisons to include FP10 and FP10MDA prescriptions.

Prisons and Area Teams should also ensure that the security arrangements meet the requirements of the NHS Counter Fraud and security management service guidance.

If prescribing controlled drugs on FP10 and FP10MDA forms, prescriptions must be written in accordance with the controlled drugs regulations and requirements. This includes the revised electronically printed versus handwritten requirements for both general medicines and controlled drugs.

FP10MDA prescriptions should be written as daily quantities with provision for doses for Saturday, Sunday and bank holidays to be dispensed in advance, on the preceding pick-up day before pharmacy closure.

Supervised consumption should be used for prescriptions of opiate maintenance medication wherever possible.

It's recommended that the availability of supervised consumption services at the chosen pharmacy is established before release and that the pharmacy is contacted to inform them of the expected FP10 or FP10MDA. This will facilitate the transfer of the prisoner into primary care especially where access to supervised consumption services is required.

Prisons need to consider when to hand over the signed prescriptions to the prisoner. A factor to consider is the security of the written prescription whilst in the prisoner’s possession before actual release from the prison grounds.

It's possible that if the prisoner is attending court, this will not result in the prisoner being released but returned to the previous prison or another prison.

Prisons should make local arrangements regarding the secure handling and destruction of the signed FP10 or FP10MDA.

On the day of their release, it's recommended that, before release, prisoners receive any supervised medication. This will reduce the risk of delayed access to subsequent doses.

At the time of prisoner release, prescribers can either issue one or more FP10s or a single FP10MDA for opiate maintenance prescriptions.

If the prisoner is likely to access the same pharmacy for at least 7 days, an FP10MDA prescription should be provided for the required time (up to 14 days).

If the prisoner is more likely to move around for the first 7 days after release, then several single FP10 prescriptions may be issued, allowing for up to seven individual supplies. It's recommended that the prescriber specifies the start date for dispensing of each in the main body of each prescription.

Prescribers should issue no more than one day’s supply on each FP10, except for weekend / bank holiday supplies.

Accessing large amounts poses a higher risk for vulnerable prisoners immediately post-release.

For all other medicines that are needed for prisoners as a result of release, an FP10 should be used if a prescription is needed.

Usual regulatory requirements apply for the dispensing of the prison-issued FP10 and FP10MDA prescriptions.

Pharmacists should continue to use their discretion and professional judgment about actions to take due to missed doses and other clinical professional issues.

Released prisoners will not be expected to pay prescription charges for the prison-issued prescriptions.

HMP and the prison name, address and prison telephone switchboard number must be printed in the box provided for the practice address on the front of the form, with the prescribing code which we require.

No signature is required on the reverse of prescriptions issued by HM Prisons for released prisoners. The patient should print their name and address, if different from the front of the form, in part 3 of the prescription form.

If the patient is homeless then the use of “no fixed abode” is acceptable in part 3 of the prescription form.

If the prescription is for a schedule 2 or 3 controlled drug and is being collected by a prisoner’s representative, the prisoner must supply an authorising letter and the representative must sign for the prescription.

For installment prescriptions this is required the first time the patient presents.

Dispensers can confirm the legitimacy of the prescription. This includes the identity of the prisoner and the prescriber, which can be confirmed by contacting the healthcare manager at the prison stated on the prescription via the HM Prison switchboard.

The telephone number can be accessed independently via directory enquiries.

After supply, the prescriptions should be should be sorted as described on the FP34C submission document. This should be done by form type, prescriber type, etc.

Forms received from prisons do not need to be separately bundled but should be placed with no charge prescriptions when submitted to us for reimbursement.

Failure to do so could result in prescription charges being deducted from the items dispensed. Reimbursement will be as for other FP10 and FP10MDA prescriptions.

Prison issued prescriptions will be allocated to the relevant prison and will be reported on, on all of our information reports and extracts as normal GP practices.

NHS England will be charged both reimbursement costs and remuneration costs. These will both need recharging to prison budgets or prison healthcare providers.

Prison issued prescriptions will be allocated to the relevant prison and will be reported on, on all of our information reports and extracts as normal GP practices.

We'll report dispensing fees and allowances for prison prescriptions dispensed in the community on the Itemised Prescribing Payment (IPP) report. A national level report is available to allow the monitoring of all prison prescribing.

Prison prescribing information is available to prisons through the Information Services Portal (ISP). Prisons that need access should contact nhsbsa.registration@nhs.net, who will then supply log in credentials.

Prisons will need to incorporate the prescribing of Controlled Drugs via prison-issued FP10 and FP10MDA prescriptions into the required Controlled Drug monitoring and reporting arrangements to the Healthcare Commission.