Emergency supplies of prescription-only medicines
There are provisions within the Prescription Only Medicines (Human
Use) Order 1997, as amended, for a pharmacist within a registered retail
pharmacy premises to make supplies of prescription-only medicines without
a legally valid prescription in an emergency. Requests for emergency
supplies can be made by either a patient or a prescriber. Further information
on the legislative conditions that apply to emergency supplies can
be found on p13 of ‘Medicines, ethics and practice: a guide for
pharmacists and pharmacy technicians’ (30th edition, July 2006).
When a request for an emergency supply is received, pharmacists should
consider the individual circumstances of the request and use their professional
judgement to determine which course of action they believe to be in the
patient’s best interests. Pharmacists should not be pressured into
making an emergency supply by their employers, colleagues or patients,
but should act in accordance with their own assessment of the situation.
Consideration must be given to making an emergency supply whenever a
patient has an urgent need for a medicine, and the medical consequences,
if any, of not making the supply must be taken into account. Pharmacists
must be satisfied that their decision will not lead to patient care being
compromised and should be able to justify their reasons for making or
refusing to make an emergency supply. Where an emergency supply is made,
the appropriate records must be maintained (see MEP, p13).
An emergency supply is a private transaction for which pharmacists may
charge. The amount charged is at the pharmacist’s discretion and
company procedures may be in place for this.
Legislation does not prevent a pharmacist from making an emergency supply
when a doctor’s surgery is open. As with any request for an emergency
supply, pharmacists must consider the best interests of the patient.
Where a pharmacist believes that it would be impracticable in the circumstances
for a patient to obtain a prescription without undue delay they may decide
that an emergency supply is necessary. Automatically referring patients
who are away from home and have forgotten or run out of their medicines
to the nearest local surgery to register as a temporary resident may
not always be the most appropriate course of action. The Society would
be concerned if pharmacists were not meeting genuine patient needs because
of a lack of appreciation of the legal position.
Where a request for an emergency supply is made by a patient, there is
a requirement for the pharmacist to interview the patient. This should
usually be a face-to-face interview. However, if this is not possible
pharmacists should explore alternative means of interviewing the patient,
such as by telephone. Regardless of the method used to interview the
patient, pharmacists should satisfy themselves that the request is genuine
and should take all necessary steps to ensure that a supply is made where
appropriate.
Pharmacists should be alert to the potential for abuse of the emergency
supply provisions. Repeated requests for an emergency supply may indicate
underlying problems that need to be addressed. However, when repeated
requests for an emergency supply are made pharmacists should still use
their professional judgement to decide on the most appropriate course
of action at the time of the request.
There are no provisions for a pharmacist to make an emergency supply
of a Schedule 2 or 3 Controlled Drug, except phenobarbitone for the treatment
of epilepsy.
Where a pharmacist is not able to make an emergency supply, he or she
should do everything possible to advise the patient on how to obtain
essential medical care.
Introduction of the Urgent Supply of Repeat Medication scheme in Scotland
complements these arrangements and permits community pharmacists in Scotland
to maintain continuity of supply of repeat medication on the NHS when
GP surgeries are closed. Established in December 2005, the facility allows
community pharmacists in Scotland who have signed the relevant patient
group direction to provide a full cycle of a patient’s repeat medication
in prescribed circumstances. Full details of this scheme can be obtained
from local NHS boards and the Scottish Executive Health Department.
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Amendment to the veterinary section of the ‘Medicines, ethics and practice’ guide
Pharmacists are advised of a correction to ‘Medicines, ethics
and practice: a guide for pharmacists and pharmacy technicians’ (30th
edition, July 2006).
On p81, Section 1.8.9(b), regarding the veterinary prescribing cascade,
currently states: “Pharmacists may obtain oral authorisation from
a veterinary surgeon for the supply of an authorised human GSL or P medicine.
It is good practice to keep a record of oral authorisations.”
This is incorrect. Under the Veterinary Regulations 2005, it is an offence
to supply a medicinal product authorised for human use for administration
to an animal, otherwise than in accordance with a prescription from a
veterinary surgeon, for administration under the cascade.
Pharmacists are asked to delete these sentences from their copies of ‘Medicines,
ethics and practice’: a guide for pharmacists and pharmacy technicians’. |
The
Pharmaceutical Journal