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Monday, 12 March, 2001, 10:45 GMT
Doctors told to improve their practice
Prescription
Many prescriptions are barely legible
Doctors have been told they should spend more time explaining treatments to patients to ensure they get properly informed consent.

In a separate move the nurses' governing body has called for the General Medical Council to clamp down on doctors whose handwriting on prescriptions is not clearly legible.

The British Medical Association (BMA) has issued all hospital doctors and medical students with guidance about the best way to obtain consent.

The BMA says that the intense pace of hospital work and the severe shortage of doctors mean that there is great pressure on the health team to make and implement decisions rapidly.

It admits that as a result making time for a full discussion about treatment options can be difficult.

The BMA says that too often responsibility for seeking consent is delegated to junior staff who are unable to answer patients' questions.

The guidance says: "Greater emphasis needs to be placed on the initial explanation given to the patient with provision for continuing opportunity for discussion in order that the patient can raise any concerns and questions."

Discussion is vital

Dr Michael Wilks
Dr Michael Wilks says proper consent should always be sought
BMA Medical Ethics Committee chairman Dr Michael Wilks said: "Gaining valid consent means giving time to patients to give the right information in the right way and providing an opportunity for patients to come back for further discussion so that they can have their questions answered.

"Consent is a process and not just a single event."

General Medical Council guidance stresses that it should normally be the clinician in charge of treatment who seeks the patient's consent and that delegation to more junior staff should be exceptional.

But Dr Wilks said the medical profession faced a dilemma.

He said: "Seeking valid consent is absolutely essential and in an ideal world, the process should never be skimped and experienced, senior medical staff should be involved.

"However all doctors, both senior and junior, are working under intense pressure and feel cheated of the time needed to discuss issues thoroughly with patients."

The guidance is designed to give all doctors the relevant legal and ethical information they need to be able to seek patient consent properly.

Handwriting

The plea for doctors to improve their handwriting comes from the UK Central Council for Nursing (UKCC).

The council is concerned that unclear prescriptions threaten patients' safety and make nurses' lives difficult.

It has asked the GMC to include the need for prescriptions to be clearly legible in a new doctors' handbook on good medical practice.

Failure to comply with the guide could lead to disciplinary action.

A UKCC spokesman said: "A revised doctors' code should have an explicit reference to ensure that prescriptions are printed and legible.

"This would enable pharmacists and practitioners administering medication - usually nurses - to do so safely and effectively."

A survey of 560 prescriptions issued at Raigmore Hospital in Inverness found that 60% of doctors' signatures were illegible.

Capital letters were not used by 30% of doctors in the prescriptions surveyed and 19% did not use the approved names for many drugs.

A GMC spokeswoman said the requirement for doctors to write clearly was included in a draft version of the new good practice guide.

She said the UKCC's view would be considered when a final decision on the content of the guide was agreed at the GMC council meeting in May.

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