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It has been more than 25 years since the NHS Management Executive issued an ‘Executive Letter’ (EL) on the responsibility for prescribing at the hospital/ GP interface.1 EL(91)127 reiterated the basic principles that prescribing responsibility is based on clinical responsibility and that legal responsibility for prescribing lies with the doctor that signs the prescription. The document also highlighted circumstances in which responsibility for prescribing should remain with the hospital consultant and recognised GPs’ apprehension of taking responsibility for unfamiliar treatments. Of particular concern was the impact on patients who might become caught in the middle of a professional dispute that could affect continuity of their treatment. Although it noted that prescribing …