Exemptions - Sale and Supply without a Prescription Flashcards
In what circumstances can you provide POM meds without a prescription?
- Patient group directions
- Patient specific directions
- Emergency supplies
- Pandemic exemptions
- Optometrist or Podiatrist signed orders for patients
- Supply of Salbutamol to schools
- Supply of naloxone by individuals providing recognised drug treatment services.
What is a PGD?
Patient group direction - is a written direction that allows the supply and/or administration of a specified medicine or medicines, by named authorised health professionals, to a well-defined group of patients requiring treatment for a specific condition.
The supply and administration of medicines under a PGD
should only be reserved for those limited situations where
this offers an advantage for patient care, without
compromising patient safety.
Give an example of a PGD in which pharmacists are empowered
Since 23 April 2012, pharmacists have been empowered by
legislation to supply, offer to supply and administer diamorphine or morphine under a PGD for the immediate, necessary
treatment of sick or injured persons.
What is a relevant prescriber?
A doctor A dentist A supplementary prescriber A nurse independent prescriber A pharmacist independent prescriber A community practitioner nurse prescriber A physiotherapist independent prescriber A podiatrist independent prescriber A therapeutic radiographer independent prescriber An optometrist independent prescriber An EEA or Swiss health professional.
What are the conditions for an emergency supply at the request of a PRESCRIBER:
- Satisfied that it is from a relevant prescriber
- It’s an emergency
- Written prescription to be provided within 72 hours
- Directions - medicine is supplied according to instructions by prescriber
- Not for Sch 1, 2 or 3 CDs (except for phenobarbital - UK prescribers ONLY & for epilepsy)
- Record kept in the POM register
What are the POM record entry requirements for emergency supply by prescriber?
To be completed on the day or the day after.
- Date of supply
- Name - strength and form
- Quantity
- Name & address of prescriber
- Name & address of patient
- Date on prescription
- Date on which the prescription is received in pharmacy
What are the conditions for an emergency supply at the request of a PATIENT:
- Interview the patient (in some can’t e.g young child or being cared for)
- Satisfied there is an immediate need and it is not practical for patient to obtain prescription without undue delay
- Previous treatment
- Dose the patient needs to take (can refer to the PMR, repeat slip, labelled med box etc)
- Not for CDs except phenobarbital for epilepsy
- Length of treatment - if Sch 4 or 5 CD or phenobarbital max quantity is for 5 days treatment. Any other POM - no more than 30 days except in the following circumstances:
- insluin, ointment, cream, inhaler (i.e packs can’t be broken) smallest pack should be supplied. if POM is oral contraceptive the full treatment cycle should be given.
If POM is antibiotic in liquid form - smallest quantity to provide a full course - Records
- Labelling - “Emergency Supply” needs to be added
What records should be kept for an emergency supply at the request of a patient?
- The date the POM was supplied
- The name (including strength and form where
appropriate) and quantity of medicine supplied - The name and address of the patient for whom
the POM was supplied - Information on the nature of the emergency, such as
why the patient needs the POM and why a
prescription cannot be obtained, etc.
Pharmacists can’t supply written prescriptions by optometrists or podiatrist unless they are qualified prescribers. However …what can we supply instead?
Can supply certain POMs directly to patients in accordance with a signed order from any registered optometrist or podiatrist.
The medicine requested must be one which can be legally sold or supplied by the optometrist or podiatrist rather than one which they can only administer.
Signed order is not a prescription so usual requirements not needed. Just need to ensure patient has been given enough advise on how to use product.
October 2014 legislation came into force that enables schools to hold emergency supplies of salbutamol inhalers. Who can provide a signed order for a school?
A written order signed by the principal or head teacher at the school must be provided to enable a supply to be made to the school.
WHAT INFORMATION SHOULD BE INCLUDED IN
THE SIGNED ORDER FOR SALBUTAMOL INHALERS?
“The order must be signed by the principal or head teacher
at the school concerned and state
(i) the name of the school for which the medicinal product
is required,
(ii) the purpose for which that product is required, and
(iii) the total quantity required”
HOW MANY INHALERS CAN A SCHOOL OBTAIN?
There is no set number by the legislation. It is dependent on factors such as:
school size, no. of sites, no. of children with asthma
WHAT RECORDS NEED TO BE KEPT
IN THE PHARMACY FOR THE SUPPLY OF SALBUTAMOL INHALERS TO SCHOOLS?
Signed order needs to be kept for at least 2 years from the date of supply. POM record in the register is good practice for audit purposes.
Date the POM was supplied
Name, quantity and where it is not apparent,
formulation and strength of POM supplied
Name and address, trade, business or profession of the
person to whom the medicine was supplied
The purpose for which it was sold or supplied.
WHAT OTHER INFORMATION COULD THE PHARMACIST BE ASKED
TO PROVIDE?
Explain how to use a salbutamol inhaler and any
associated information
Advise schools on the selection of the most appropriate
spacer device for the different age groups and how to use them correctly.
What happened in Oct 2015 about naloxone?
In October 2105 legislation enabled lawful drug treatment service to obtain naloxone from a wholesaler, and people engaged in the supply, to do sow ithout a prescription, PGD or PSD.
