Doctors are to be banned from prescribing Botox by phone, email, video-link or fax under new guidance from the General Medical Council (GMC), it was announced today (12th July).

The change means that doctors must have face-to-face consultations with patients before prescribing Botox and other injectable cosmetics to ensure they fully understand the patient’s medical history and reasons for wanting the treatment.

Under current GMC guidance doctors must adequately assess the patient’s condition before prescribing remotely and they must be confident they can justify the prescription. Where doctors cannot satisfy these conditions, they must not prescribe remotely.

The new guidance, which comes into force on 23rd July2012, updates and strengthens these rules.

It introduces a complete prohibition on prescribing cosmetic injectables, such as Botox, without a physical examination of the patient. Doctors who continue to prescribe Botox or similar products remotely will be putting their registration at risk.

The GMC recognises that remote prescribing may be appropriate for some drugs and treatments for some patients but stresses that doctors must consider the limitations of any electronic communication with their patient.

The guidance, which will be issued to every doctor in the UK, states: ‘You must undertake a physical examination of patients before prescribing non-surgical cosmetic medicinal products such as Botox, Dysport or Vistabel or other injectable cosmetic medicines. You must not therefore prescribe these medicines by telephone, fax, video-link, or online.’

Niall Dickson, Chief Executive of the GMC, today said: ‘We recognise that patients can benefit from communicating with their doctor by email, phone, or video-link or fax and that is fine as long as it is done safely, but our new guidance makes clear that doctors must now not prescribe medicines such as Botox remotely.

‘These are not trivial interventions and there are good reasons why products such as Botox are prescription only. We are clear that doctors should assess any patient in person before issuing a prescription of this kind. So while remote prescribing may be the right answer in many situations, this is not one of them.'

Katherine Murphy, Chief Executive of the Patients Association, added: ‘The Patients Association welcomes all guidance that strengthens rights and helps inform choice. Face to face appointments give patients the most appropriate opportunity to question clinicians directly about their care. Doctors must encourage a partnership approach, ensuring that patients are equal partners in their care and the decisions made about it.’

The new guidance on remote prescribing is part of wider updated guidance, Good practice in prescribing and managing medicines and devices which is set to be published later in the year and followed an extensive consultation on this issue with almost 200 responses received from medical, pharmaceutical and other health care professions and patient safety organisations.’

A copy of the new remote prescribing guidance can be read on the GMC’s website www.gmc-uk.org/guidance/ethical_guidance/13594.asp