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Letters to the Editor
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Controlled drugs
Clarification
From Mr R. A. Hancocks, MRPharmS
I think Priya Sejpal (PJ, 10 December 2005, p719) has missed the
point I was trying to make (PJ, 3 December 2005, p685). I was not referring
specifically to amending computer-generated prescriptions but to any
prescription, however written or generated.
The regulations, as I understand them, remove the need for a prescription
to be written in the prescriber’s own hand provided it is indelible,
and signed and dated by the prescriber. Explanatory note 9 to the regulations
(SI 2005/2864) elaborates as follows: “Regulation 9 amends regulation
15 of the 2001 Regulations to enable prescriptions to be written in any
form, including typing, printing and any other mode of reproducing words
in a visible form, with only the signature necessarily being handwritten.”
“Any other mode of reproducing words in a visible form” is
an interesting phrase. Does it not follow that it is lawful that a CD prescription
might
be written by another person provided it is written in indelible ink
and it is then signed and dated by the prescriber. What is the difference
between a prescription generated by a machine and one produced by a person?
I ask this question because I suspect many pharmacists will have interpreted
the removal of the handwriting requirement to mean that they can add
or alter the prescription when it does not fulfil the prescription requirements.
This will be especially so in hospitals where junior doctors often have
little idea how to prescribe a CD properly and much time is wasted trying
to get the doctor to get it right. The guidance we need should clarify
whether or not a pharmacist can add the strength or form when it is missing,
change the strength when a non-existent strength has been prescribed,
add the address, and add the total quantity in words and figures where
necessary.
And, not that I would want to, because I believe we have better things
to with our time, but could a pharmacist write the entire prescription
for the doctor to date and sign? This brings me back to my original point:
if all these examples are lawful then the regulations have turned prescription
requirements into endorsement requirements and this adds little to the
secure management of Controlled Drugs.
Roger Hancocks
Worksop,
Nottinghamshire
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PRIYA SEJPAL, pharmacist adviser, Royal Pharmaceutical
Society, replies:
As Mr Hancocks correctly states the recent changes
to the Misuse of Drugs Regulations 2001 have removed the requirement
for Controlled Drug
prescriptions
to be written in a doctor’s own handwriting. However, this amendment
does not allow pharmacists to make technical changes to CD prescriptions.
It would be possible from the outset for a pharmacist to write the entire
prescription, and then have a doctor sign it. However, after the prescription
has been signed the pharmacist would be unable to make changes.
There are proposals to enable pharmacists to make technical changes
to CD prescriptions where the prescriber’s intentions are clear,
however these amendments are not expected to occur until later in 2006.
Pharmacists will be notified when
this change takes place. |
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The
Pharmaceutical Journal