In the UK, NHS GPs are subject to strict legal and professional guidelines when prescribing controlled medications such as tramadol and codeine phosphate. These medications are opioids and classified under the Misuse of Drugs Regulations 2001, meaning they carry a risk of dependence, abuse, and adverse side effects.
Under General Medical Council (GMC) guidance, and NHS England prescribing policies, a GP must ensure they have enough information about a patient’s medical history, current health status, and treatment needs before prescribing any medication — especially controlled drugs. This typically requires a face-to-face consultation, or at the very least, a real-time consultation (via phone or video call), particularly when initiating treatment.
Tramadol, although not a controlled drug until 2014, is now classified as a Schedule 3 controlled drug, and codeine phosphate is a Schedule 5 medicine. Prescribing either without appropriate clinical assessment could put the patient at risk of harm and may breach the GP’s duty of care.
It can be legal to prescribe tramadol or codeine phosphate without seeing a patient in person, but only under certain circumstances. If the GP already has a pre-existing clinical relationship with the patient — such as regular consultations or past in-person reviews — and access to the patient’s full medical records, then prescribing remotely may be justified. However, it must be clear that:
The prescription is in the patient’s best interest
The GP can confirm the patient’s identity
The decision is well-documented with clinical justification
For new patients or first-time prescriptions, it is highly unlikely to be appropriate — and could be considered negligent or even unlawful, especially if the prescriber lacks access to sufficient clinical information.
In summary, it is not outright illegal for an NHS GP to prescribe tramadol or codeine phosphate without seeing a patient first — but it is only acceptable in very specific, well-documented situations. GPs must exercise clinical judgment, ensure patient safety, and comply with NHS and GMC guidelines. Prescribing these medications without proper evaluation or a prior clinical relationship would typically fall short of professional standards and could carry legal consequences.
To know more visit: https://www.thefirs.org.uk/