Hancock urged to give pharmacists freedom to manage shortages


Pharmacists, GPs and patients have joined together to call for a change in the law to reduce bureaucracy and speed up patient access to medicines when they are in short supply.

A joint letter to Matt Hancock MP, Secretary of State for Health and Social Care, calls for pharmacists to be able to alter prescriptions to minimise the impact of medicine shortages on patient care.

The letter, co-signed by the Royal Pharmaceutical Society, the British Medical Association, the Royal College of GPs, patient group National Voices and others, calls on the Government to amend medicines legislation to allow pharmacists to make changes to prescriptions and provide a different quantity, strength, formulation or generic version of the same medicine if it is in short supply.

The letter also calls on the Government to work with stakeholders to implement the changes ahead of the end of the UK transition from the EU at the end of this year.

At present, community pharmacists are legally obliged to contact prescribers, or refer patients back to prescribers, to amend original prescriptions even for minor adjustments such as supplying two packets of 20mg tablets if the 40mg packet prescribed is out of stock.

This is frustrating for patients, pharmacists and doctors causes delays in access to medicines and takes up health professionals’ time which could be better spent supporting patient care. The proposal is restricted to the way a prescribed medicine is provided, rather than changes to the medicine itself.

President of the Royal Pharmaceutical Society Sandra Gidley said:


“We urgently need this change ahead of the triple whammy of a second wave of coronavirus, the flu season and a potential no-deal Brexit, all of which would again place heavy demands on the medicines supply chain and primary care services.  Pharmacists are experts in medicines and need greater flexibility under the law to make simple changes to prescriptions that help patients get the medicines they need when they need them. It makes no sense to have to turn patients away without their medicine when the answer could literally be sitting on the shelf.”

Chair of the British Medical Association’s GP Committee Dr Richard Vautrey said:


“At a time of significant increase to GP workload and the problems with supply of medications, allowing pharmacists to make these changes so that patients can obtain their medicines in a timely manner can only be a good thing for both doctors and patients. GP practices have to deal with a significant amount of bureaucracy which takes precious time away from seeing patients and changes like this will go some way in addressing that, especially as we head into winter and at a time when we are seeing the number of Covid cases increase again.”


Chair of the Royal College of GPs Professor Martin Marshall said:


It can be frustrating for GPs, pharmacists and patients when prescriptions can’t be dispensed due to shortages – and that minor adjustments to prescriptions which could be dispensed can’t be made by an experienced pharmacist without being reviewed by a GP. Unfortunately, not only does this step increase GP workload, but often it slows down patient access to medication. Pharmacists are highly skilled in their area of expertise – medicines – so trusting them to make appropriate and sensible decisions regarding medicines, depending on supplies, will in turn allow GPs to focus on patients who need our care the most.”


National Voices Chief Executive Charlotte Augst said:


“People who use medicines have told us that they experience delays and shortages not only as an inconvenience, but that it can cause them anxiety and distress.


“Where a medicine can be safely swapped for one that is just a different package size or quantity, it is better for everyone for this option to be discussed with the patient and a shared decision to be made that enables the pharmacist to simply provide the medicine that helps the patient. Anything else just adds inconvenience and ultimately cost for no added benefit.”


You can read the full letter here.


Do you think pharmacists should be allowed greater powers to make minor changes to prescriptions in time of medicine shortages?



Export of certain drugs banned ahead of Brexit


The UK Government is banning the export of certain key drugs to alleviate shortages and ‘protect UK patients’ weeks ahead of the 31st October Brexit deadline.


Most of the 24 medicines that wholesalers will not be able to sell outside of the UK from midnight tonight are hormone replacement therapies (HRT) used to treat menopause symptoms.


The list also includes EPiPens, anti-blood-clotting drugs and hepatitis B vaccines.


Pharmacists will also get special powers under a new provision to alter prescriptions of anti-depressant fluoxetine.


Ministers are writing to drugs wholesalers to warn the UK medicines regulator will take action to stop parallel exporting.


This is when wholesalers import medicines to the UK but sell them on elsewhere in the EU when prices in other markets rise – a practice that would become more attractive if the pound weakens.


Stocks of HRT and some other drugs have been disrupted in recent months because of manufacturing, supply and demand issues.


Dr Farah Jameel, who represents GPs through the British Medical Association, said this had gone on “far too long”.


“Drug supply issues are common, and while clinicians can prescribe alternative medication, amending a patient’s prescription takes time and this can significantly add to our already heavy workload – particularly if the issue is ongoing.


“More importantly, prescribing alternative interim medication might not always help to fully relieve a patient’s symptoms, further delaying their treatment and causing avoidable, unnecessary distress to the patient.


“The menopause can be a very difficult time for many women, so it’s essential that they have access to the medication they need when they need it.”


Yet restrictions on other drugs come as the chances of a no-deal Brexit rise.


While pharmaceutical companies are supposed to be building up reserves of key medicines, the public spending watchdog warned last month overall stocks are still ‘unknown’.


Scottish health secretary Jeane Freeman said plans to stockpile, warehouse and fast-track medicines are “not normal or sensible”.


UK health and social care secretary Matt Hancock said: “The new measures we’re introducing today will help us ensure patients get the medicines they need and the high-quality care they deserve.


“Helping the NHS is a priority for this government, and people should be fully reassured that we will always act to ensure that there is an adequate supply of the medicine you need.”


Dr Rick Greville, director of supply chain at the Association of the British Pharmaceutical Industry, welcomed the “precautionary measures”.


“It means that these stockpiles of medicines which companies have built over previous months are better protected and available for use only by the NHS patients for which they were intended.”


This story was supplied as part of our partnership with healthandcare.scot.