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Supply issues

PSNC proposes change to NHS rules to allow pharmacists to refuse prescriptions

Simon Dukes, chief executive of the PSNC, said that pharmacists should be able to use “their professional discretion to manage the demand for medicines better”.

Simon Dukes, chief executive officer of the Pharmaceutical Services Negotiating Committee, leaning on a pillar

Source: Jeff Gilbert

Simon Dukes, chief executive of the Pharmaceutical Services Negotiating Committee, said that pharmacists should be able “to use their professional discretion to manage the demand for medicines better”

The Pharmaceutical Services Negotiating Committee (PSNC) has called for pharmacists to be allowed to refuse to dispense prescriptions if a drug is in short supply.

The measure was suggested in addition to powers proposed by the government on 7 December 2018, which would allow pharmacists to substitute medicines during shortages without consulting a patient’s doctor.

Under the proposed government protocol, pharmacists would be allowed to respond to a shortage in one of four ways, including dispensing a reduced quantity of the drug.

In addition to this, the PSNC has suggested that “it makes sense to relax the NHS terms of service obligation on pharmacists to allow pharmacists to refuse supply if necessary”.

Simon Dukes, chief executive of the PSNC, said: “This would allow pharmacies to avoid dispensing drugs at a significant loss and incurring costs that their business could not survive, but it would also allow pharmacies to refuse to dispense complete prescriptions where, for example, patients were seeking several months’ worth of a medicine at once, or where they already had sufficient stock from a previous prescription.

“Again, this would allow pharmacists to use their professional discretion to manage the demand for medicines better and to prioritise stock for patients who need it most in a shortage situation.”

The suggestion formed part of the PSNC’s ‘Brexit Contingency Planning: Update for community pharmacies’ statement, which laid out “what measures might need to be in place in addition to the six-week stockpile that the government has asked the manufacturers of prescription medicines to hold in the UK”.

Dukes added that in addition to stockpiling medicines, “there will need to be processes in place to help community pharmacies and other healthcare providers to work together to manage any shortages that do occur”.

Ash Soni, president of the Royal Pharmaceutical Society, told The Pharmaceutical Journal that while a refusal to dispense a prescription “is a bit inflammatory”, the PSNC’s suggestion would introduce “an opportunity from a pharmacy and a patient perspective to look at validation to make sure that the medicine is needed”.

He continued: “What we shouldn’t be doing is refusing patients — we need to be really clear about the use of language. From our perspective, we need to make sure that patients have appropriate access but they understand that there may be times where we will ask them to look at what they’ve got and to see if they’ve got enough to get them by until we can get more stocks in.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205877

Readers' comments (1)

  • The suggestion from the PSNC that a pharmacy should refuse to dispense a prescription is nothing less than preposterous, however tempting it might be. I wonder whether they have carefully thought though the ramifications for patients if pharmacies throughout the land take it upon themselves to refuse the dispensing of prescriptions.

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