Prescribing for travelling abroad

Pre-existing conditions

Medication required for a pre-existing condition should be provided in sufficient quantity to cover the journey and to allow the patient to obtain medical attention abroad. If the patient is returning within the timescale of a normal prescription (usually one and no more than three months) then this should be issued, providing it is clinically appropriate. Patients travelling abroad should always have clear information about any existing medical conditions and medications and should keep a written record. This may be required to export their medication or to bring it back into the UK. The generic names, as well as the trade names, may be required to accurately identify any medicines.

 

Just-in case treatments

An NHS prescription should not be provided for medication which is requested solely in anticipation of the onset of an ailment whilst outside the UK, but for which treatment is not required at the time of prescribing (e.g., travel sickness, altitude sickness). Patients should be advised to purchase these items locally prior to travel; advice is available from community pharmacists if required. A private prescription may be provided for any prescription-only medicines.

 

Taking controlled drugs abroad

Department of Health guidance recommends that, in general, prescriptions for controlled drugs should be limited to a supply of up to 30 days treatment. Exceptionally (to cover a justifiable clinical need and after consideration of any risk) a prescription can be issued for a longer period, but the reasons for the decision should be recorded in the patient’s notes.

Patients who are carrying certain controlled drugs abroad or into the UK for less than three months for their own personal use do not need a personal export or import licence. They should carry a letter from the prescribing doctor with the following details:

• patient’s name, address and date of birth

• a list of the medicines prescribed, including doses, strength, frequency and total quantity; it must be evident that the patient is not carrying more than a 3-month supply from both the travel dates and quantities of medication listed on the letter or prescription

• the signature of the person who prescribed your drugs and their professional

registration details

• the full travel itinerary including outward and return dates of travel

 

Controlled drugs should be:

• carried in original packaging

• carried in hand luggage (airline regulations permitting)

• carried with a valid personal import/export licence (if necessary; see below)

 

Persons travelling abroad (or visitors travelling to the UK) in excess of three months and carrying controlled drugs will require a personal export or import licence. A personal licence has no legal standing outside the UK and is intended to assist travellers passing through UK customs controls with their prescribed controlled drugs. It is always advisable to contact the embassy, consulate or high commission of the country to be visited regarding their policy on the import of controlled drugs, as the legal status of UK prescription only (POM) controlled drugs varies between countries.

 

Patients travelling abroad for more than three months

NHS England Standard General Medical Services Contract states that a patient should be removed from the list of a practice if the patient has “been absent from the United Kingdom for a period of more than three months”. The test for the practice informing NHS England ought to be this person has retained a sufficient connection to the UK to continue to be habitually resident here and thus can justify remaining on the practice list. The BMA GPC advice on Prescribing in General Practice advises that “The NHS accepts responsibility for supplying ongoing medication for temporary periods abroad of up to three months. If a person is going to be abroad for more than three months, then only a sufficient supply of his/her regular medication should be provided to enable them to get to the destination and find an alternative supply. NHS prescriptions must never be obtained by relatives or friends on behalf of patients who are currently abroad, irrespective of such factors as owning a house in the UK or paying UK taxes.” It is for the prescriber to consider this guidance and decide in which circumstances they will give up to three month’s supply of medicines, e.g., drugs that require frequent monitoring may not be prescribed or length of supply may be limited due to safety concerns. It is wise for the patient to check with the manufacturer that medicines required are available in the country being visited. It is also worth advising that some UK prescription only medicines can be purchased without a prescription from pharmacies in some countries.