About prescribing

In the UK, the clocks go forward 1 hour at 1am on the last Sunday in March, and back 1 hour at 2am on the last Sunday in October.

Nervecentre safely and automatically manages clock changes. Nervecentre displays the local time, but stores times in Greenwich Mean Time (GMT). This means the differences between two times is always accurate even when the clocks change.

During a clock change:

• Nervecentre merges any doses that are due so that the doses are not lost or duplicated.

• Medications that are due at a specific time of day are still due at that time of day.

• If a medication is due every x hours, Nervecentre adjusts the time the medication is due so the interval between doses remains the same.

Example 1: Clocks forwards, lose 1 hour

On the last Sunday in March, if you prescribe a medication that starts between 01:00 and 02:00 GMT, Nervecentre automatically changes the times to BST. In the diagrams below, this hour is highlighted in pink.

On the last Sunday in March, at 00:30 GMT , you prescribe a medication with 2 doses an hour apart. You enter the start time 01:30 GMT . Nervecentre knows that at 01:00 GMT, the clocks move forward an hour. So Nervecentre automatically changes the time you entered to 2:30 BST . On the MAR, you can see the medication needs to be administered at 02:30 BST and 3:30 BST .

On the last Sunday in March, at 00:00 GMT , you prescribe a medication with 3 doses an hour apart. You enter the start time 00:30 GMT . Nervecentre knows that at 01:00 GMT, the clocks move forward an hour. On the MAR, you can see the medication needs to be administered at 00:30 GMT , 02:30 BST , and 03:30 BST .

Example 2: Clocks backwards, gain 1 hour

On the last Sunday in October, if you prescribe a medication that starts between 01:00 and 02:00, you can choose if the medication starts in the hour before or after the clock change. In the diagrams, these hours are highlighted in teal.

On the last Sunday in October, at 01:00 BST , you prescribe a medication with 2 doses an hour apart. You enter the start time 01:30. Nervecentre knows that at 02:00 BST, the clocks move backwards an hour. You can choose to start administering the medication before the clock change, at 01:30 BST, or after the clock change at 01:30 GMT. You choose to start administering the medication after the clock change at 01:30 GMT . On the MAR, you can see the medication needs to be administered at 01:30 and 2:30 GMT .

On the last Sunday in October, at 01:00 BST , you prescribe a medication with 2 doses an hour apart. You enter the start time 01:30. Nervecentre knows that at 02:00 BST, the clocks move backwards an hour. You can choose to start administering the medication before the clock change, at 01:30 BST, or after the clock change at 01:30 GMT. You choose to start administering the medication before the clock change at 01:30 BST . On the MAR, you can see the medication needs to be administered at 01:30 BST and 1:30 GMT .

The image below shows how you can choose the hour before or after the clock change when prescribing on a desktop.

The image below shows a medication which needs administering at 01:30 BST and 1:30 GMT.

Nervecentre has rules for when a regular dose starts after a stat dose.

Some medications need the dose to be reduced or increased throughout the course duration. Clinicians can interpret the schedule for reducing or increasing doses differently. For clinical safety, Nervecentre has rules for reducing and increasing doses.

If a reducing or increasing course starts:

• Today, and the time for administering some doses has passed

  Nervecentre omits the doses for today. A warning appears to explain that some doses have been omitted. If you want to administer a dose that Nervecentre has omitted, you can prescribe a stat dose.

  For example, on Monday at 14:00 you prescribe a reducing course that has a morning and afternoon dose. The dose reduces from 100 mg to 70 mg over 4 days. Nervecentre omits the Monday morning dose of 100 mg because the time for administering that dose has passed. The dose on Monday afternoon is 100 mg and the dose on Tuesday morning is 90 mg.

• On a future day

  Nervecentre starts the reducing or increasing course at the start of that day. Nervecentre ignores the start time you enter.

  For example, you prescribe a reducing course that has a morning and afternoon dose. The dose reduces from 100 mg to 70 mg over 4 days. You set the start date to tomorrow and the start time to 14:00. The first dose of 100 mg is due tomorrow at 8:00, and not at 14:00.

  If you want to start a reducing or increasing course part way through the day, the prescriber must omit some doses. For example, they must omit the morning dose at 8:00.

  Read more about omitting doses

These rules don't apply to medications with a constant dose.