NHS prescribing guidelines

Want to understand how the NHS decides what medicines to use and how to prescribe them safely? This page breaks the core ideas down into simple, usable steps — whether you’re a patient checking your script or a prescriber wanting quick reminders.

How NHS prescribing guidance works

The NHS relies on a few trusted sources: NICE (National Institute for Health and Care Excellence) sets evidence-based recommendations, the BNF (British National Formulary) gives day-to-day dosing and interaction details, and local formularies adapt national advice to local services. Together these documents tell clinicians which drugs are effective, how to dose them, what monitoring is needed, and when to prefer one treatment over another.

Some medicines need extra controls. For example, clozapine requires regular blood tests and a strict monitoring protocol. Controlled drugs have tighter legal rules around prescribing and storage. The guidance doesn’t only cover which drug to use — it covers safety checks, monitoring intervals, and when to stop a medicine.

Practical tips for patients and prescribers

If you’re a patient: ask your prescriber where their choice comes from. Say things like “Is this in the local formulary?” or “Do I need blood tests while taking this?” Keep a list of all medicines you take, including OTC and supplements — many interactions show up only when both prescription and non-prescription items are considered. If you buy meds online, check the pharmacy is registered with the General Pharmaceutical Council (GPhC) and prefer UK-registered suppliers for NHS-level checks.

If you prescribe: use NICE pathways for common conditions, check the BNF for dosing and interactions, and follow your local formulary for preferred options. Document the indication and planned review date on the prescription — that makes audit and follow-up easier. For high-risk medicines, set reminders for monitoring (labs, BP, ECGs) and explain monitoring to the patient in plain language so they know what to expect.

Electronic prescribing tools reduce errors but aren’t foolproof. Always cross-check high-risk doses and consider a second pair of eyes for complex regimens or when switching anticoagulants, antibiotics for resistant infections, or psychotropics with major interactions.

What about online pharmacies and importing meds? The NHS guidance doesn't remove legal requirements: prescriptions must be valid and appropriate. If a medicine requires specialist monitoring (like clozapine or methotrexate), avoid buying from sources that can’t guarantee safe follow-up. Rogue sites may sell poor-quality products or incorrect dosages — check registration, read verified reviews, and when in doubt, ask your GP or pharmacist.

One small habit helps a lot: keep a clear, updated medication list and share it at every appointment. That single step prevents many errors and makes NHS guidance work the way it should — keeping people safe and treatments effective.