Patients waiting up to three weeks for vital medication due to out of date laws - NPA
The National Pharmacy Association (NPA) are urging the government to change out of date legislation that prevents pharmacists from supplying a suitable alternative when a medicine is out of stock.
Pharmacies are warning the current situation is posing a risk to patient safety, with patients with serious health issues facing unnecessary delays to get hold of medicines.
A new survey of over 400 pharmacies found that 97 per cent reported patients waiting for at least a day whilst highly trained pharmacists have to request a new prescription from the prescriber. Some pharmacies have even reported patients waiting for over three weeks to get a new prescription for certain medicines.
Legislation from 1968 currently prevents pharmacists from providing safe alternatives where a medicine is out of stock, forcing patients back to their GP or other prescribers. This also leads to significant additional work for over stretched pharmacy and GP surgery teams.
For example, this outdated legislation prevents pharmacists from supplying tablets rather than capsules or two 10mg tablets in place of one 20mg tablet, when clinically appropriate and where formulations are equivalent, to help mitigate supply issues.
For example, this outdated legislation prevents pharmacists from supplying tablets rather than capsules or two 10mg tablets in place of one 20mg tablet, when clinically appropriate and where formulations are equivalent, to help mitigate supply issues.
95 per cent reported that some patients simply went without medication when being referred back to their prescriber, despite a pharmacy having a safe alternative formulation in stock that they were prevented from dispensing.
98 per cent of pharmacies also reported to the NPA being unable to supply medicines to patients at least once a day despite having a safe alternative in stock.
Pharmacies have told the NPA they have had distressed patients waiting for over a week for changes to be made for a different formulation of quetiapine, a medication to manage the symptoms of bipolar and schizophrenia.
Another pharmacist reported that an 8-year-old patient with a UTI was forced to visit A&E due to a strength of cefalexin being out of stock, despite the pharmacist having an alternative formulation available. The patient would have had to wait several days for their GP to amend the prescription, due to the incident occurring on a bank holiday. Pharmacies also regularly encounter situations where a prescriber has chosen a product that is out of stock, while an equivalent medicine is readily available. Current rules prevent pharmacists from making such substitutions, even though they would be clinically suitable and safe for patients.
The NPA warns that this situation poses a serious risk to patient safety, as medicine shortages have become increasingly frequent and severe in recent years. They are calling on the government to urgently update decades old legislation to allow pharmacists to make substitutions where a medicine is not in stock, but a safe alternative is. This includes allowing pharmacies change the strength, formulation or in some cases provide a suitable alternative medicine where there are supply issues and this is clinically appropriate and equivalent. Pharmacists are often asked by GPs and hospital doctors to suggest clinically appropriate alternatives or available medications when medicines are unavailable.
Olivier Picard, Chair of the National Pharmacy Association said:
"Pharmacists are highly trained medicines experts who already advise GPs on clinically suitable alternative medicines that is available in their pharmacy.
“The current status quo is not only frustrating for patients, it is also dangerous.
“It is madness to send someone back to their GP to get a prescription changed when a safe alternative is in stock. It risks a patient either delaying taking vital medication or forgoing it altogether, which poses a clear risk to patient safety.
“A lot has changed in 60 years. Medicine shortages are now becoming common place and pharmacists are delivering more clinical care than ever before.
“We urgently need amended legislation, allowing pharmacists the flexibility to make safe prescription substitutions, where appropriate, when a medicine is unavailable."
