Yazdan (prescription validity) Flashcards
What details need to be included on a prescription?
Signature of prescriber
Address of prescriber
Particulars of prescriber
Date
Patient name
Patient address
Patient age- legal requirement for patients under 12
Signature
Prescriptions need to be signed ink by an appropriate practitioner in their own name.
An advanced electronic signature can be used to authorise an electronic prescription. They are linked uniquely to the signatory.
Date
An NHS prescription is valid for up to 6 months from the appropriate date.
For an NHS prescription this date is either the date the prescription is signed or the date indicated as the date the prescription should not be dispensed before.
For private prescriptions the date will always be the date it was signed.
Indelible
Prescriptions need to be written in ink that will not come off- they may be written, or computer generated, or typed.
Electronic prescriptions
Normally sent to the pharmacy by the prescribing organisation.
Copies on the patients phone do not normally meet the requirements of an advanced electronic signature.
Repeat prescriptions
Refers to medication which the doctor has agreed can be requested on a repeat basis without you needing to see or spend to a doctor each time.
Most long term medication is placed on repeat.
Repeatable prescriptions
Private prescriptions which contain a direction that they can be dispensed more than once e.g. repeat x5.
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 5 times (dispensed 6x in total).
Prescriptions for Schedule 2 and 3 CDs are not repeatable but those for schedule 4 and 5 are.
Prescriptions from the EEA or Switzerland
Prescriptions and repeatable prescriptions issued by an approved health professional in an approved country are legally recognised in the UK.
Approved health professionals
Approved health professionals include doctors and dentists as well as other professions with prescribing rights e.g. podiatrists, nurses, optometrists, paramedics, pharmacists, physiotherapists.
Approved countries
Approved countries comprise EEA countries and Switzerland:
e.g. Austria, Belgium, Cyprus, Denmark, France, Germany, Norway, Spain.
If the prescription is not valid…
Use professional judgement and find best way to help the patient.
Foreign prescriptions
Even if the prescription requirements have been written in a foreign language the prescription is still legally acceptable.
However, you need to have enough information to enable the safe supply of medicines considering patient care and wellbeing.
Checking the registration of approved health professionals
An international database of prescribers does not exist so it may not always be possible to check the registration of approved health professionals.
If in doubt do not dispense. Can refer to 111 or out of hours GP.
Prescriber contacted (PC)
Use when there is a missing dose, strength, quantity.
You can contact the prescriber and endorse the missing details.
Endorse ‘PC’ with your initials and date on the prescription in the endorsement column.
Prescriber not contacted (PNC)
When a prescription is presented with a missing presentation and the prescriber cannot be contacted, the prescription can be endorsed and dispensed as long as you have sufficient information to make a professional judgement.
You should endorse ‘PNC’ with your initials and date in the endorsement column.
When a prescription is presented with a missing quantity and the prescriber cannot be contacted you may supply sufficient amount to complete 5 days treatment (unless quantity is recorded in SCR)
Endorsement
Required if there are different pack size for one product.
To endorse: quantity dispensed over the pack size that was used.
Specials and imported unlicensed medicines
There is no endorsement required for these products (Part VIIB) apart from cleaning the sourcing fee with ‘SP’ or ‘ED’.
SP- the unlicensed medicine is manufactured under manufacturer ‘specials’ license or Wholesale Dealer License by the MHRA. Need to endorse:
- initials ‘SP’ to claim additional fees for dispensing unlicensed medicines
- pack size from which the order was supplied
- invoice price per pack from which the product was supplied
- manufacturers license number
- batch number of the unlicensed medicine
ED- only applied if the unlicensed medicine has been prepared under the manufacturing section 10 exemption. Need to endorse:
- name
- quantities
- cost of ingredients used
The Broken Bulk (BB)
Enables pharmacy teams to claim payment for a complete pack of an eligible product where only a part pack has been dispensed.
Contractors should only claim BB where it is unlikely that they will be able to dispense the reminder within the following six months. Endorse:
- letter BB
- amount over pack size used
When a BB claim is accepted, contractors are reimbursed for the complete pack dispensed. Subsequent prescriptions for the same medicine received during the next six months do not need an endorsement of BB as it will be deemed that supply was made using the residual balance.
NHS blacklist
Part XVIIIA informs of the drugs, medicines and other substances that may not be ordered under the National Health Service. Not allowed on green NHS prescription.
If received you can:
- refer back to prescriber for an alternative product to be prescribed
- issue a private prescription
- sell product to patient over the counter instead if item has GSL or P status
Prescription colours
Green
- GP
- Community practitioner nurse prescriber
- Nurse independent prescriber
- Supplementary prescribers
- Hospital unit
Blue
- GP
- Nurse independent prescriber
- Independent prescribers
- Supplementary prescribers
- Hospital unit
Yellow
- Dentist
Lilac
- Community practitioner nurse prescriber
- Nurse independent prescriber
White online
- Controlled drug requisition form
Pink
- Prescribers of Schedule 2 and 3 CDs in private sector
Forged prescriptions
- Is a large or excessive quantity prescribed?
- Is it an inappropriate medicine for the condition being treated?
- Is prescriber known?
- Is patient known?
- Has the title ‘Dr’ been inserted before the signature?
- Is the behaviour of the patient indicative e.g. aggressive?
- Is the medicine commonly misused?
Can check signature against a genuine prescription.
Confirm details with the prescriber.
Use contact details for the prescriber that are obtained from a source other than the suspicious prescription.
Reporting concerns
Depending upon the nature of the fraudulent prescription, use professional judgement to assess whether or not it is a matter that requires referral to the police, NHS Counter Fraud Services or whether the matter can be resolved by discussions with the patient and prescriber.
Borderline substances
In certain condition some foods and toilet preparations have characteristics of drugs and the Advisory Committee on Borderline Substances (ACBS) advises as to the circumstances may be regarded as drugs.
List A - products
List B - conditions (cross index listing clinical conditions and the products which the ACBS has approved for the management of those conditions)
Selected List Scheme (SLS)
The SLS includes drugs, medicines and other substances which should only be prescribed for certain conditions under the circumstances listed in the Drug Tariff.
These drugs and devices are only for patients with the stated medical conditions and not for any other purpose.
If a drug is in Part XVIIIB prescribers must order these drugs by endorsing SLS. A dispenser cannot add the SLS endorsement to a prescription only the prescriber can do this.
If the SLS endorsement is missing the prescription should not be dispensed and will not be [assed for payment by NHS Prescription Services.
Inpatient Prescription Chart
Its purpose is to reduce the risk of prescribing, dispensing and administration error by health professionals through standardised presentation of information on the intended use of medicines for an individual patient, and through standardised presentation of medicines information in all high risk healthcare settings.
