Medication Policies

Repeat prescriptions

Prescriptions can be requested via our secure online form please include your full name, date of birth and names and details of the medication your require. Or by completing a form at reception (requests are not taken by phone due to the risk of error).

Repeat prescriptions should be requested between 2 and 7 days before they are needed.

Prescriptions can be sent electronically to a pharmacy of your choice – please email us if you would like to change your nominated pharmacy.

If you would prefer to have medication posted to your home, a number of online pharmacies can be found online via search engines. Some local pharmacies will also deliver if you contact them directly.

If you are on stable long-term prescriptions, you may be suitable for repeat dispensing, which allows pharmacies to dispense prescriptions without having to contact the practice each month. Please email the practice or make an appointment with our clinical pharmacist if you would like to discuss this. 

Duration of prescriptions

The Oxfordshire Integrated Care Board (who sets policies for Oxfordshire GPs) has instructed GP practices that prescriptions should normally only be provided for one month at a time. There are some exceptions to this, for example, longer prescriptions can be provided for some medications (e.g. HRT) or temporarily if a patient is going away. If you are having difficulty with requesting monthly prescriptions you may want to consider repeat dispensing or online postal pharmacies (see above).

Private prescriptions

If specialist care is accessed privately, it is the responsibility of the private clinician to provide prescriptions. If medication is intended to be prescribed long-term a private specialist may request that it is taken over by a GP. There is no obligation for GPs to prescribe a medication that was started by another clinician and a GP must be satisfied that any prescription is safe and appropriate, and in line with NHS guidelines and their prescribing competencies. Medications started privately will only be continued to be prescribed by a GP if they are a) in line with NHS treatment guidelines b) align with the local prescribing policy c) are deemed to be safe and appropriate for the patient being treated d) might normally be prescribed by a GP (i.e. not a specialist medication).

Some specialist medications (e.g. stimulants for ADHD, immunosuppressants, hormones used in gender affirming treatment) require a “shared care agreement”. This allows GPs to prescribe specialist medications under the oversight of a specialist, who continues to review the patient’s treatment. Although there are established local shared care agreements with NHS specialists, these are not in place for private prescribers and so we do not accept shared care agreements with private specialists. This means that any medication requiring a shared care agreement that is initiated by a private clinician will need be prescribed directly by that clinician.

Prescriptions started abroad

As with private prescriptions, prescriptions started abroad will only be issued by a GP if they are felt to be in line with NHS treatment and local prescribing rules, safe and appropriate for the patient, and suitable for a GP to prescribe.

Benzodiazepines and Z-drugs

Benzodiazepines (diazepam [Valium], alprazolam [Xanax], lorazepam, clonazepam temazepam etc) and Z-drugs (zopiclone and zolpidem) were previously commonly used for sedation, anxiety and insomnia. However, medical treatment has now moved away from these medications because of the risk of dependence, addiction, abuse and overdose. At Cowley Road Medical Practice we feel that the risks of these medications outweigh any benefits, and so we do not prescribe them. Safer medications or non-drug treatments may be offered as an alternative.

Sedation for procedures

We do not prescribe sedation for procedures performed elsewhere (e.g. dentist or hospital treatment). The appropriateness of sedation must be assessed by the clinician performing a procedure, and any prescription required must be prescribed by them.

Sedation for flying

We do not prescribe sedation for flying. This is a common policy in GP practices and is due to the risks involved (sedation makes it difficult to respond to emergencies and increases the risk of blood clots), the fact it goes against prescribing (BNF) and treatment (NICE) guidance, the potential legal issues associated with travelling with controlled drugs, and the fact that flight anxiety does not come under the general medical services contract and so is outside of our remit. Cognitive behavioural techniques are the recommended treatment for fear of flying, this website provides some of the resources available. 

Stimulants for attention deficit hyperactivity disorder (ADHD)

Stimulants (e.g. lisdexamphetamine [Elvanse], methylphenidate [Medikinet/Xaggitin/Concerta/Delmosart]) are specialist medications used to treat ADHD. These medications are always started by an ADHD specialist and require continued monitoring and review by specialists in accordance with national guidelines. GPs sometimes prescribe these medications as part of a “shared care agreement” where a GP agrees to provide a prescription for a medication that is monitored by a specialist.

GPs in Oxford have previously had shared care agreements with the Oxfordshire ADHD services but many GPs are now withdrawing these because patients are not being regularly reviewed in clinic, as is required by national guidelines. This means that GPs take on the risks of prescribing medications that are outside of their competencies.

Because of these issues CRMP is not currently taking on shared care agreements for stimulant medications with local NHS services. We also do not take on shared care agreements with private providers (see above). This means that stimulant medication prescriptions must be provided directly by specialist services (either NHS or private).

Medication to postpone menstruation

Medication to delay periods can be purchased privately via a variety of online pharmacy services.

Emergency contraception

Emergency contraception pills (the “morning after pill”) can be bought from pharmacies or obtained by contacting Sexual Health Oxfordshire.

Domperidone for breast feeding

Domperidone is recommended by some breast-feeding services to increase milk production. Domperidone is “black listed” in the Oxfordshire formulary due to lack of evidence of benefit and an association with potentially fatal heart rhythm problems. This means that it should not be prescribed by GPs and we do not prescribe it at the surgery.