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Pharmacists could overrule GP decisions during medicine shortages, DHSC says

Pharmacists could be given the power to overrule GP prescriptions and supply patients with alternative drugs if there is a medicines shortage, the Government has said.

The Department of Health and Social care said today that it is consulting on a 'protocol' to allow pharmacists to 'provide an appropriate alternative' should there be a medicines shortage, a plan which they defended as a 'sensible approach'.

In a leaked DHSC memo obtained by the Times, officials linked the possibility of medicines shortages to a 'no-deal' Brexit.

GP leaders urged the Government to allow GP to have their say on the changes, and warned against rushing Brexit contingency plans.

Back in August health secretary Matt Hancock wrote to GPs telling them they will continue to have access to medicines for their patients in the event of a no-deal Brexit, and that there was no need to ‘stockpile additional drugs' or medical devices.

But last month, Mr Hancock admitted the Government is building extra ‘refrigeration capacity’ in case a no-deal Brexit leaves the UK short of certain medicines.

In a statement made today, a DHSC spokesperson said: ‘In the unlikely event of a shortage of any medicine it’s vital that patients continue to receive the high level of treatment they expect.

‘We are consulting on the introduction of a strict protocol, which would be developed in collaboration with doctors, to allow our highly-trained pharmacists to provide an appropriate alternative should there be a shortage of certain types of medicines.

'This is a sensible approach that should reduce the time taken for alternatives to be provided to patients. The deal secured by the Prime Minister delivers for our NHS and we continue to urge Parliament to back it. As a responsible Government we are planning for all eventualities.'

But BMA GP Committee chair Dr Richard Vautrey called the situation ‘very concerning’, and told the Government that 'far more time' would be needed to 'adequately consider' the proposals.

He said: 'While we understand the urgency of the situation, a consultation about something as crucial as the supply of medicines, put out with such a short timescale it is very concerning.

'The BMA believes that Brexit will have a severe impact on the supply of medicines and the overall delivery of healthcare in the UK and we should have far more time to adequately consider the Government’s proposals for change.'

He continued: ‘GPs and in fact, all doctors, will understandably be apprehensive about plans which could adversely impact patient prescriptions and their ability to deliver effective care and so it’s only right that doctors should have their say over these proposed changes.

‘Despite the pressure to rush through contingency plans, we must not lose sight of our continuing role in ensuring the delivery of high quality care to patients.’

However, BMA sessional GP subcommittee chair Dr Zoe Norris said the new proposals could save GP time.

She said: ‘There are already lots of drug shortages and the system for dealing with this is hugely variable. We all spend unnecessary time issuing alternative scripts many times a day.

‘If Brexit does happen, this already grim situation can only get worse. GPs will not have time to sort out alternatives, so I'm very happy to leave it to our pharmacy colleagues and if patients have particular needs I'm sure they are able to deal with them.’

But Dr Norris then questioned how ‘routine pharmacy dispensing will be affected’ if pharmacists take on this additional work, and warned that ‘if repeat scripts are delayed I suspect it will come back to the GP surgery again’.

Both the BMA and RCGP have backed a second Brexit referendum, with the college going against normal protocol to take a political stance on the issue, after its council voted to ‘oppose Brexit’ last month.

The BMA previously warned that leaving the EU without a deal in place could be ‘potentially catastrophic’, while NHS Providers said ‘the entire supply chain of pharmaceuticals could be adversely affected’ in the event of a no-deal Brexit in another letter leaked to The Times.

Back in September, pharmacy leaders called for pharmacists to be able to change GP prescriptions to ‘therapeutically equivalent generics’ when dispensing drugs, in order to allow them to earn more money, as they gain more profit from generics than branded generic drugs.

Readers' comments (15)

  • could and will be 2 totally different things

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  • The thin end of the wedge. Beware the empire building of pharmacists.

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  • I’m all for pharmacists being part of the greater healthcare environment but who would have legal responsibility in the event of a patient developing a significant problem as a result of not receiving a medication prescribed by a doctor because the pharmacist won’t dispense it?

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  • Overdue! Only if it is really supply problems, not just thier wholesaler....
    Just let us know so we can object if wrong....

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  • |another last man standing | GP Partner/Principal|07 Dec 2018 10:58am

    If the patient didn't get what the doctor prescribed, the doctor has no legal responsibility, simples.

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  • Once taking any meaningful responsibility dawns on them they usually run for the hills.

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  • David Banner

    Hope these pharmacists have rock solid indemnity or they will deeply regret this.

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  • Agree with policenthieves

    Pharmacists are (correctly) very strict at making sure that they are practicing within their competence. How many patients have all of us seen with insect bites because the pharmacist was not willing to reassure the patient themselves.

    If changing a medication, anything more than a generic to branded switch would surely need an entire consultation - and without access to history/ bloods etc it is just not going to happen that often.

    The only thing to avoid is the pharmacist making a switch then chucking all responsibility on to the GP by writing to them and expecting us to check their work.

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  • Agree with another last man standing. If they don't do it'll come back to us to find the appropriate drug. More help the better.

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  • AlanAlmond

    Who carry’s the can?

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