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DH alarm over pharmacy drugs access scheme



Exclusive: The Department of Health has requested talks with pharmacy leaders after they gave the green light for the national roll-out of a scheme giving patients access to a wide range of medicines without a prescription.

The National Pharmacy Association (NPA) scheme will be offered to 12,500 pharmacies and would see patients given access to 16 medicines without a prescription, including salbutamol inhalers, trimethoprim and sildenafil.

The DH said it wanted pharmacists to consider if the inclusion of antibiotics was ‘absolutely necessary’ amid fears it could put strategies to combat increasing antimicrobial resistance ‘at risk’.

The GPC also raised grave concerns about the scheme, which will allow pharmacists to dispense prescription-only medicines under a patient group direction (PGD).

The NPA scheme has been piloted by the Day Lewis Pharmacy chain since October, but will be offered to all 12,500 NPA members from January.

Before signing up to the scheme, pharmacists have to obtain additional training online.

Patients will be able to obtain medicines after completing an online medical questionnaire and having a face-to-face consultation with the pharmacist or using a walk-in service.

The NPA says there have been no adverse events in the pilot so far and that all the official guidelines on non-NHS PGDs were followed in the development of the scheme, even though official guidance from the Medical and Healthcare Products Regulatory Agency urges ‘particular caution’ when issuing PGDs for antibiotics.

Deborah Evans, NPA director of pharmacy, said ‘robust protocols’ would be in place.

She said: ‘The service is all about improving access to self-care and increasing patient choice, without compromising quality.’

Kirit Patel, chief executive of Day Lewis Pharmacy, said: ‘The service is convenient, and will make the most out of pharmacists’ skills as experts in medicines while freeing up GPs’ time.’

But after being alerted to the scheme, a DH spokesperson said the chief pharmaceutical officer, Dr Keith Ridge, was requesting a meeting with Day Lewis Pharmacy and the NPA to discuss the plans.

‘Decisions about treatment should be based on an assessment of a patient’s needs and circumstances,’ the DH said.

‘It is important that if getting medicines from other sources, patient safety is not compromised.

‘Particular caution should be exercised in the use of antibiotics. Pharmacists should consider whether their inclusion in a PGD is absolutely necessary.

‘This will make sure strategies to combat increasing antibiotic resistance are not put at risk.’

Dr Bill Beeby, chair of the GPC clinical and prescribing committee, said: ‘PGDs of this nature are not allowed in practices – the asthma nurse cannot give out a salbutamol inhaler, despite her training. How can it be safe for pharmacies to sell them after an e-learning module?’

Dr Kevin Gruffydd-Jones, a GP in Box, Wiltshire, who has been involved in the development of several asthma guidelines, said he was ‘very concerned’ at salbutamol inhalers being made available without prescription and warned it was essential safeguards were in place to prevent patients ‘going from pharmacist to pharmacist getting reliever medication alone’.

Earlier this year, the supermarket chain Asda announced it was to dispense salbutamol inhalers under a PGD without a doctor’s prescription.

Click here to read the full list of drugs in the PGD