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  1. Home
  2. Prescribing Standards

Responsible clinical decisions

Our Prescribing Standards

Every consultation is reviewed by a qualified prescriber to assess whether treatment is safe, suitable and clinically appropriate for the individual patient.

If treatment is not suitable, we may ask for more information, recommend GP review or refuse the request.

View our medicine safety protocols Contact the pharmacy team

Clinical approval is never automatic

❝ We only supply prescription medicines when they are clinically appropriate. Before treatment is approved, the information provided is reviewed against the patient’s symptoms, medical history, current medicines and relevant safety criteria.❞

Abbas Kanani
Superintendent Pharmacist

Treatment is subject to clinical approval

We may ask further questions

Unsuitable requests may be refused

Higher-risk medicines need extra checks

Support continues after supply

Our clinical approach

Six prescribing principles

These principles guide how our pharmacy team assesses online consultations and makes safe, patient-centred supply decisions.

01 / Safety first

Patient safety comes first.

We will not supply treatment where the information provided suggests it may be unsafe or inappropriate.

02 / Suitability

Treatment must be clinically suitable.

The requested medicine must be appropriate for the patient’s symptoms, history and risk factors.

03 / Accuracy

Complete information is essential.

Accurate consultation answers allow the clinical team to assess suitability safely.

04 / Further checks

More information may be needed.

We may clarify answers, request evidence or ask for consent to contact a patient’s GP.

05 / Refusal

Treatment may be refused.

If a medicine is unsuitable, we may refuse supply and advise the patient to seek appropriate medical care.

06 / Aftercare

Support continues after supply.

Patients can contact the pharmacy team for advice about dosage, side effects and treatment concerns.

Clinical review

What we check before supplying treatment

The checks required depend on the treatment, but every decision considers the information needed to assess benefits, risks and alternatives.
Check What we look for Why it matters
Age Whether the treatment is suitable for the patient's age. Some medicines are not appropriate for younger or older patients.
Symptoms What the patient is experiencing and how severe it is. Some symptoms need testing, GP review or urgent care.
Medical history Existing or previous medical conditions. Some conditions increase risk or make treatment unsuitable.
Current medicines Prescription, over-the-counter and relevant recreational substances. To identify interactions and contraindications.
Allergies Medicine or ingredient allergies. To avoid unsafe supply.
Previous treatment What has been tried before and what happened. Helps assess dose, response and side effects.
Pregnancy or breastfeeding Where relevant to the requested treatment. Some medicines are unsuitable in pregnancy or breastfeeding.
Dose requested Strength, frequency and any proposed escalation. Unsafe or inappropriate dose requests may be refused.
Red-flag symptoms Symptoms that could suggest serious illness. These may require urgent or face-to-face care.
Eligibility criteria BMI, diagnosis, treatment history or other specific criteria. Some medicines have defined supply requirements.

What we look for
Whether the treatment is suitable for the patient's age.
Why it matters
Some medicines are not appropriate for younger or older patients.

What we look for
What the patient is experiencing and how severe it is.
Why it matters
Some symptoms need testing, GP review or urgent care.

What we look for
Existing or previous medical conditions.
Why it matters
Some conditions increase risk or make treatment unsuitable.

What we look for
Prescription, over-the-counter and relevant recreational substances.
Why it matters
To identify interactions and contraindications.

What we look for
Medicine or ingredient allergies.
Why it matters
To avoid unsafe supply.

What we look for
What has been tried before and what happened.
Why it matters
Helps assess dose, response and side effects.

What we look for
Where relevant to the requested treatment.
Why it matters
Some medicines are unsuitable in pregnancy or breastfeeding.

What we look for
Strength, frequency and any proposed escalation.
Why it matters
Unsafe or inappropriate dose requests may be refused.

What we look for
Symptoms that could suggest serious illness.
Why it matters
These may require urgent or face-to-face care.

What we look for
BMI, diagnosis, treatment history or other specific criteria.
Why it matters
Some medicines have defined supply requirements.

Clarifying information

When we may ask for more information

Sometimes the information provided is not enough to make a safe decision. In these cases, we may contact the patient before approving or refusing treatment.

  • Answers are unclear or inconsistent
  • Important medical history is missing
  • A higher-risk medicine has been requested
  • Side effects have been reported
  • A dose change has been requested
  • Weight, BMI or treatment history needs confirmation
  • Current medicines need clarification
  • Symptoms need further assessment

Need help?

Questions about your consultation?

Our pharmacy team can help if you are unsure what information to provide or need to discuss a treatment concern.

Contact the pharmacy team

The safest decision

When treatment may be refused

We may refuse treatment if the requested medicine may be unsafe, unsuitable or inappropriate. Refusing treatment is sometimes the safest clinical decision.
Reason treatment may be refused Example
Unsafe medicine interaction Sildenafil requested by a patient taking nitrates, nicorandil, riociguat or poppers.
Unsuitable medical history Weight-loss treatment requested by someone with a relevant high-risk medical history.
Red-flag symptoms Severe chest pain, severe abdominal pain, eye symptoms with suspected herpes or symptoms needing urgent review.
Inappropriate dose request Requesting an unsafe dose increase or a dose outside appropriate use.
Missing information Not enough information has been provided to assess suitability.
Needs face-to-face care Symptoms require physical examination, diagnostic testing or urgent assessment.
Pregnancy or breastfeeding Where relevant to the requested treatment.
Treatment criteria not met Strength, frequency and any proposed escalation.
Red-flag symptoms BMI outside the relevant criteria for weight-loss treatment.
Concern about misuse Information suggests unsafe, inappropriate or repeated use.

Example
Sildenafil requested by a patient taking nitrates, nicorandil, riociguat or poppers.

Example
Weight-loss treatment requested by someone with a relevant high-risk medical history.

Example
Severe chest pain, severe abdominal pain, eye symptoms with suspected herpes or symptoms needing urgent review.

Example
Requesting an unsafe dose increase or a dose outside appropriate use.

Example
Not enough information has been provided to assess suitability.

Example
Symptoms require physical examination, diagnostic testing or urgent assessment.

Example
Where relevant to the requested treatment.

Example
Strength, frequency and any proposed escalation.

Example
BMI outside the relevant criteria for weight-loss treatment.

Example
Information suggests unsafe, inappropriate or repeated use.

A refusal is a clinical safety decision. Where appropriate, we will explain the next step, such as GP review, urgent care or a different treatment pathway.

Treatment-specific standards

Different medicines need different checks

The same approval rule is not applied to every medicine. Our assessment changes according to the treatment's known risks, contraindications and monitoring needs.

Height, weight and BMI
Previous and current weight-loss treatment
Diabetes medicines
Pregnancy or breastfeeding
Severe gastrointestinal symptoms
Weight-related health conditions
Current dose and dose escalation
Pancreatitis or gallbladder history
Eating disorder risk
Side effects and treatment tolerance

Nitrate, nicorandil or riociguat use
Heart symptoms
Recent heart attack or stroke
Diabetes or cardiovascular risk indicators
Poppers or recreational substance risk
Blood pressure concerns
Suitability for sexual activity
Eye or vision conditions

Age and suitability
Previous treatment
Sexual side effects
PSA or prostate advice where relevant
Hair-loss pattern
Mental health
Breast symptoms
Pregnancy handling warnings

First or recurrent outbreak
Pregnancy
Eye symptoms
Outbreak frequency
Location and severity
Immune suppression
Need for STI testing
Renal cautions for antiviral treatment
View our medicines safety protocols

Shared responsibility

Patient responsibilities

Safe online prescribing depends on accurate information. Patients must complete consultations honestly and tell us about conditions, medicines, allergies, pregnancy status where relevant and previous side effects.

01

Answer consultation questions accurately and completely.

02

Disclose prescription, non-prescription and relevant recreational substances.

03

Tell us about allergies and previous side effects.

04

Do not order medicine for another person unless the service expressly allows it.

05

Read the patient information leaflet supplied with the medicine.

06

Follow the dosage and treatment instructions provided.

07

Contact us if side effects or treatment concerns occur.

08

Seek urgent help for severe or rapidly worsening symptoms.

Safe, confidential care

Records and confidentiality

We keep appropriate records of consultations, clinical decisions, supplies, refusals and patient communications. Patient information is handled confidentially and used to support safe care.

Your information supports safer decisions.

Clinical records help our team understand what was reviewed, why a decision was made and what advice was given.

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Need help with treatment suitability?

Our pharmacy team can help if you are unsure whether a treatment is suitable or have questions before ordering.

Contact the pharmacy team View clinical governance
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