W6 Getting the right medicine to the right person l and ll Flashcards
1
Q
What are Dispensing Doctors?
A
- Exception to the rules
- Certain rural areas with little to no CP to supply (controlled localities)
- GPs may apply to dispense NHS prescriptions
- No “prejudice” to existing service
2
Q
Which Overseas prescriptions can UK receive?
A
Switzerland & EEA (European Economic Area)
* Prescriptions and repeatable prescriptions issued by an approved health professional in an approved country are legally recognised in the UK
* If the prescription originates from a country or
prescriber not on the approved list the prescription is not valid and you should use your professional judgement (e.g. refer to local GP), in finding the best way to help the patient
3
Q
What are the Switzerland & EEA prescription requirements?
A
- Patient’s full first name(s), surname and DATE OF BIRTH REQUIRED unlike UK
- Prescriber’s full FIRST NAME(s), surname, professional qualifications, direct contact details including email address and telephone or fax number (with international prefix), work address (including the country they work in)
- Name of the medicine (brand name where appropriate), pharmaceutical form, quantity, strength and dosage details
- Prescriber signature
- Date of issue (valid for up to six months)
- Even if the prescription requirements have been written in a foreign language the prescription is still legally acceptable. However, you will need to have enough information to enable the safe supply of medicines considering patient care and wellbeing.
- If it is not possible to confirm the registration status, then it may still be possible to make a safe and legal supply in the interests of patient care
- No obligation to supply if uncomfortable- although if patient is harmed then you could be questioned
4
Q
Which countries are part of the EEA? (for info)
A
Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Republic of Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, The Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland
5
Q
Private Prescriptions
What are the requirements? (7)
A
- Outside the NHS
- Patient is charged the cost of the item(s) plus a mark-up, and a fee levied by the pharmacist as payment for dispensing the item(s).
- Requirements:
- the patient’s details
- details of the medication to be supplied
- the signature of the prescriber
- the address of the prescriber
- an indication of the prescriber type
- an appropriate date.
- It is a legal requirement to record the sale or supply of all prescription-only medicines (POMs) not supplied via the NHS
6
Q
Repeat Prescriptions (NHS)
What is it labelled as so that you know it is a repeat?
How long is this prescription valid for?
A
- An authorising prescription will have ‘RA’ printed on it and will be signed by the doctor.
- This prescription is valid for up to one year
- The associated Repeat Dispensing issue forms will be marked ‘RD’ and are only valid for the period indicated on the repeat authorisation prescription.
- Pharmacist will keep the authorising form and the first repeat issue form after dispensing for the first time.
- Patient can look after the remaining repeat issue forms or pharmacist can store
7
Q
Repeat Prescriptions (Private)
A
- Written/printed statement on prescription. E.g. Repeat x 3
- In this example, the item may be supplied a total of four times
- the one original dispensing, followed by three repeats
- The first dispensing must take place within 6 months of the date on the prescription.
- If a number is not stated, they can only be repeated once (dispensed twice) unless the prescription is for an oral contraceptive in which case it can be repeated five times (dispensed six times in total)
- No time limit for remaining repeats, use professional judgement
- The patient can choose to have repeats dispensed from different pharmacies and can retain the prescription.
- To maintain an audit trail mark on the prescription the name and address of the pharmacy from where the supply has been made and the date of supply
8
Q
Military Prescriptions
A
- Some military medical centres have outsourced the dispensing process to designated community pharmacies under a Ministry of Defence (MOD) contract
- Community pharmacies not covered by the contract will not routinely handle military prescriptions
- Military prescriptions are written on a military form FMed 296
- Pharmacies with a dispensing contract with the MOD will usually invoice the MOD directly
- For a non-contracted pharmacy, the prescription should be treated as a private prescription
- Therefore, charge the patient the appropriate fee
9
Q
Optometrist and Podiatrist Signed
Orders
A
- Certain POMs can be given directly to patients in accordance with a signed patient order from any registered optometrist or podiatrist.
- Must be medicine which can be legally sold or supplied by the practitioner
- Rather than one which they can only administer.
- Additional Supply Optometrists can issue signed patient orders for an extended range of medicines.
- The practitioner must provide sufficient advice to enable the patient to use the medicine safely and effectively.
- Pharmacists should ensure that the medicine is labelled accordingly as a dispensed medicinal product
- Appropriate record must be made in the POM register.
- Any additional counselling
10
Q
Patient Group Directions (PGDs)
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.
- Advantage for patient care, without compromising patient safety?
- Only developed after careful consideration of all options
-including prescribing, by medical or nonmedical prescribers. - Prescription-only medicines supplied under a PGD should be labelled in the same way as if supplied against a prescription.
11
Q
Patient Specific Directions
What information is required?
A
- Not defined in legislation
- Traditional written instruction, signed by a prescriber
- To be supplied and/or administered to a named patient after assessment.
- The information required in a PSD at a minimum should include:
- Name of patient and/or other individual patient identifiers including age if a child
- Name, form and strength of medicine (generic or brand name where appropriate)
- Route of administration
- Dose
- Frequency
- Date of treatment/number of doses/frequency/date treatment ends as applicable.
- Signature of prescriber and date PSD written.
- There should, wherever possible, be separation of prescribing and supply/administration roles
12
Q
Supply of Medicines to Schools
A
- Schools can obtain supplies of adrenaline autoinjectors (AAIs) and/or salbutamol inhalers from a pharmacy on a signed order. These can then be administered in an emergency, by persons trained to administer them, to
pupils previously prescribed such medication and where parental consent has been received. - The number that can be obtained by individual schools is not specified in legislation.
- The signed order needs to be retained for two years from the date of supply or an entry made into the POM register.
13
Q
What are the School supply requirements? (6)
A
- Name of the school
- Product details (including spacer if relevant)
- Strength (if relevant)
- Purpose for which the product is required
- Total quantity required
- Signature of the principal or headteacher
- Ideally, appropriately headed paper should be used; however, this is not a legislative requirement
14
Q
Supply of Naloxone
A
- Supply of naloxone by individuals employed or engaged in the provision of recognised drug treatment services
- Human Medicines (Amendment) (No.3) Regulations 2015
- Under arrangements made by
- an NHS body
- a local authority
- Public Health England
- Public Health Agency
- Groups of people include:
- family members
- peers
- staff in regular contact with drug user
- This is a service that can continue to be provided by appropriately trained staff in the absence of the RP
15
Q
Wholesaling
Who is responsible for the overseeing of this?
A
The Medicines and Healthcare products Regulatory Authority (MHRA)
is the regulatory body with the responsibility for oversight and enforcement of the wholesale distribution of medicines.
