Dispensing when a pharmacy is closed
England and Wales
Legislation has been passed enabling NHSE/CCGs to authorise dispensing practices in England to dispense to all patients (including formerly non-dispensing patients) during a pharmacy closure and until 30 June 2020.
However, the regulations make clear that NHS England must first commission dispensing doctors to do so and until then, this could constitute a breach of the contract.
In Wales, health boards are expected to work with pharmacies to ensure business continuity plans. Any closure should be short term and the GPhC has provided advice to pharmacies about activities which can continue in the absence of a pharmacist. The Welsh dispensing regulations have not been updated despite our request.
Subject to approval by local NHSE organisations and/or CCGs, we expect practices in England to be able to dispense during bank holidays if pharmacies are closed.
In doing so, practices should have regard to how practical it is for a non-dispensing patient to access an open pharmacy.
When to dispense
England and Wales
We advise the option to dispense is used only when non-dispensing patients are struggling to obtain their medication from their normal pharmacy, for example, when patients are being asked to self-isolate at home due to symptoms of COVID-19 and medications are needed to treat them.
You should contact your CCG and LMC for clarification, but prescriptions dispensed to non-dispensing patients should be accounted for, and submitted for pricing, in the usual way.
If your practice is not a dispensing practice, a local dispensing practice can dispense medications for your patients. However, practices need to bear in mind the workload implications for the dispensing practices and check with them before doing this.
Disruption to earnings
Agreement has been reached with the Scottish Government that no practice will face any financial detriment as a result of COVID-19 and that this explicitly includes dispensing practices. It has also been agreed that payment on account will be based on 100% of the sum due. These measures are set out in a revised statement of financial entitlements.
You should encourage patients with pre-existing conditions to order medication online and via EPS. Work closely with community pharmacies to help providers of repeat prescription ordering and use delivering services where available.
Medication durations should not be altered from the practice’s usual routine, nor should additional quantities of medication be prescribed when it is not clinically necessary.
The NHSE/I letter of preparedness advises that practices should put patients on electronic repeat dispensing 13x28 day supplies to manage supply issues apart from where that could be detrimental to patients.
It is advised that practices should introduce or maximise the use of online repeat prescribing systems wherever possible. For some vulnerable patients this may not be possible and options such as working with a community pharmacy or a mailbox at the front door of the practice should be considered.
Practices should not change their repeat prescription durations or assist patients in trying to stockpile. Practices should consider moving patients to serial prescribing as soon as possible, but are advised to stagger this so that annual reviews do not all fall due at once.