Pharmacy leaders call for action to prevent hold-ups which can occur when stocks run out as pharmacists do not currently have the power to alter a prescription
Patients with ADHD and bipolar disorder are facing waits of several weeks for their medication due to “out-of-date” legislation prohibiting pharmacists from supplying a safe alternative when a first-choice prescription is out of stock.
Pharmacy leaders have called for action to prevent hold-ups, which can occur when supply has run out, as pharmacists do not currently have the power to alter a prescription. For instance, pharmacists are prohibited from supplying tablets rather than capsules, or two 10mg tablets in place of one 20mg tablet.
This can leave patients travelling from pharmacy to pharmacy to get their prescription, or having to go back to the GP to get a new prescription to match the medication available in a pharmacy. In some cases, it can leave patients waiting for weeks for their prescription, the National Pharmacy Association (NPA) said.
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The regulations impact England, Wales and Northern Ireland, but not in Scotland, where health officials have interpreted the guidelines differently, causing fewer issues, the NPA said.
A poll conducted by the NPA on 400 pharmacists found that 97 per cent said their patients had been forced to wait at least a day when the pharmacist had to request a new prescription from the prescriber – in the community this will usually be a GP or a practice nurse.
And 95 per cent reported that some patients went without medication when being referred back to their prescriber, despite a pharmacy having a safe alternative in stock that they were prevented from dispensing.
Issues with quetiapine, a treatment for the symptoms of bipolar and schizophrenia, frequently came up in the survey. One strength would often be out of stock, but an alternative strength would be available, so a prescription could still be made safely if the guidelines did not prevent it from happening.
Instead, people with acute mental health issues were being sent back to the GPs for new prescriptions and waiting for changes to be made. NPA members said it left their patients “understandably very distressed”.
Another pharmacist reported issues substituting Methylphenidate – an out-of-supply ADHD treatment. In another case, one member described how an eight-year-old with a water infection was forced to visit A&E due to a certain formulation of antibiotic being out of stock, despite the pharmacist having a different formulation available.
Other pharmacists reported challenges with Ramipril, a treatment for high blood pressure, and being unable to simply switch a prescription for tablets to one for capsules.
The NPA is calling on the Government to change the laws, which have been in place since 1968, to allow pharmacists to make substitutions where a medicine is not in stock, but a safe alternative is.
In August, the Government pledged to consult on enabling community pharmacists to have the flexibility to supply an alternative strength or quantity, against a prescription written by another prescriber. The NPA said that the current situation is posing a risk to patient safety, as patients with serious health issues are facing unnecessary delays for vital medicines. In some cases, patients have been forced to wait up to three weeks, it added.
Olivier Picard, chairman of the National Pharmacy Association, said: “Pharmacists are highly trained medicines experts who already advise GPs on clinically suitable alternative medicines that are 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 commonplace 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.”
The Department of Health and Social Care has been approached for comment.