MEP 5

Question 1

Can advanced electronic signatures be accepted for CD 2 and 3 drugs?

Answer 1

Yes where the electronic prescribing service (EPS) is used

Question 2

Does the strength of a medicine always need to be on a prescription?

Answer 2

If there is more than one strength available, yes

Question 3

What does the quantity on a CD 2 and 3 prescription need to be written as?

Answer 3

Words and figures

Question 4

1) What does the DOH recommend that the maximum prescribed quantity of Schedule 2, 3 and 4 drugs on one prescription (in terms of days)?
2) Is this a legal restriction?

Answer 4

1) 30 days

2) Not a legal restriction but prescribers should be able to justify the quantity requested

Question 5

If a patient is homeless, what should you put in the address section on a prescription?

Answer 5

No fixed abode

Question 6

When a controlled drug prescription is written by a dentist, what phrase must be present?

Answer 6

“For dental treatment only”

Question 7

When a controlled drug is supplied, it is a requirement to mark the prescription with what?

Answer 7

mark the prescription with the date of supply at the time the supply is made.

Question 8

True or false:Sugar free/colour free products have a greater potential for abuse, so the RPS advises that these are only supplied when specifically prescribed

Answer 8

True

Question 9

Would the instructions “as directed” be acceptable on a controlled drug prescription?

Answer 9

No “One as directed” would be acceptable

Question 10

If a woman of child bearing age is on valproate, do they have to be on the pregnancy prevention programme?

Answer 10

Yes- Government warning came in April 2018 stating they should not be prescribed it unless on PPP

Question 11

True or False: For instalment prescriptions, there is approved wording set out by the Home Office

Answer 11

True

1) Please dispense instalments due on pharmacy closed days on a prior suitable day.
2) If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment
3) Consult the prescriber if three or more consecutive days of a prescription have been missed
4) Supervise consumption on collection days
5) Dispense daily doses in separate containers

Question 12

For CD 2 and 3 prescription, if either the words or figures (but not both) of the quantity has been omitted, can a pharmacist amend this?

Answer 12

1) Yes- should mark the prescription to show amendment has been made
2) (name, date, signature and GPhC registration
number)

Question 13

If there is a minor typographical error/spelling mistake on a CD 2/3 prescription, can a pharmacist amend this?

Answer 13

1) Yes- should mark the prescription to show amendment has been made
2) (name, date, signature and GPhC registration
number) .

Question 14

For CD 2/3 prescriptions, can a pharmacist amend a date, dose, form or strength?

Answer 14

No

Question 15

True or false:Private CD 2/3 prescriptions must be written on standardised forms

Answer 15

TRUE

Question 16

If a hospital is dispensing a private CD 2/3 prescription within the same legal entity, is a standardised form required?

Answer 16

No

Question 17

What must you have on a private CD prescription to identify the prescriber and what is it?

Answer 17

A prescriber identification number must be included on standardised private prescriptions.It is a number issued by the relevant NHS agency and the prescriber can obtain it from their local primary care organisation

Question 18

Do vet CD prescriptions need to be written on a standardised private CD form?

Answer 18

No

Question 19

If a healthcare professional is picking up a CD2 on behalf of a patient, what is required?

Answer 19

1) Name of HCP

2) Address of HCP Identity required - if they do not have identity, it is up to discretion of pharmacist

Question 20

If a drug misuser wants a representative to collect a CD on their behalf, what are pharmacists advised to do?

Answer 20

1) Obtain a letter from the drug misuser that authorises and names the representative. (This includes those detained in police custody who should supply a letter of authorisation to a police custody officer to present to the pharmacist)
2) A separate letter should be obtained each time and the record of supply should be included about the representative in the CD register

Question 21

If a CD script is meant to be supervised but a representative with a consent letter from the patient turns up to the pharmacy, what should you do?

Answer 21

1) You should contact the prescriber before the medicine is supplied to the representative – since supervision will not be possible. It is legally acceptable to confirm verbally with the prescriber that they are happy with this arrangement since supervision, while important, is not a legal requirement under the 2001 Regulations
2) It would not be necessary to contact the prescriber if the person has been detained in police custody and the representative collecting the dose is a police custody officer

Question 22

Does phenobarbital require safe custody?

Answer 22

No

Question 23

What drugs need to be kept under safe custody?

Answer 23

1) Schedule 1, 2

2) Schedule 3 There are some exemptions e.g. tramadol

Question 24

Does safe custody apply to returned CDs from patients?

Answer 24

Yes until destroyed

Question 25

What controlled drug schedules need to be denatured before disposal?

Answer 25

Schedules 1, 2, 3 and 4 (part 1)

Question 26

What is the difference between destroying CDs that are pharmacy stock, and that are patient returned POMs?

Answer 26

1) Pharmacy stock needs a witness by authorised person for CD2
2) patient returned returned POMs do not - however it is preferable for denaturing to be witnessed by another staff member

Question 27

For patient returned CDs, should a record be made when destroying them?

Answer 27

A record should not be made in the Controlled Drugs register but records of patient- returned Schedule 2 Controlled Drugs and their subsequent destruction should be recorded in a separate record for this purpose

Question 28

Do you need an authorised witness when destroying CD unwanted stock/patient returned expired stock?

Answer 28

1) Yes if schedule 2

2) Good practice for schedule 3