New GMC guidance that warns GPs to prescribe Botox to named patients only is common sense and errs appropriately on the side of caution, says the Medical and Dental Defence Union of Scotland (MDDUS) today (Wednesday, 24 September 2008).

Until now, doctors have been able to issue group prescriptions of the muscle freezing toxin, used to paralyse muscles that cause wrinkles, without knowing the patients concerned. A nurse or other practitioner then performed the injections.

GMC guidance now states that a GP must be familiar with a patient's medical history, or at least have seen a picture of the patient for assessment. The guidance makes it clear that group prescriptions - or Patient Group Directions - may be suitable for the supply and administration of some injectable medicines.

"Group prescriptions for Botox could flout good medical practice and could have serious medico-legal consequences," says MDDUS medico legal adviser George Fernie. "Patient-specific prescriptions are simply common sense, and err appropriately on the side of caution.

"If a patient is to be injected, a doctor must assess where to inject - and where not. Clearly, to do that, you need to know your patient. You don't have to perform the injection yourself - a nurse can do it - but you should make the assessment.

"A group prescription is like a group birthday card - fine for some, but not appropriate for all."

MDDUS is a medical defence organisation providing access to professional indemnity and expert medicolegal advice for doctors, dentists and other healthcare professionals throughout the UK.

MDDUS