BMA Objects to Pharmacist Prescription Freedom

Peter Russell

January 31, 2019

The British Medical Association (BMA) has objected to new powers granted to pharmacists to change GP patient prescriptions to alternatives in the event of a 'no-deal' Brexit.

From the 9th February 2019, pharmacists would be able to alter the strength, quantity or type of drug, without a GP's permission - as long as it has a similar effect as the original.

The measures were contained in the Human Medicines (Amendment) Regulations 2019, presented to Parliament almost 2 weeks ago.                                                    

The BMA said it was not appropriate for pharmacists to switch drugs without authorisation from an independent prescriber.

Amendments to the legislation followed discussions between the Department of Health and Social Care (DHSC) and pharmacists, doctor, and patient representative bodies. It came as a new general practice contract gave a greater role for pharmacists to alleviate pressure on primary care.

No-deal Brexit Preparations

The change to the powers was given fresh impetus with the possibility of a 'no-deal' Brexit in March. Last year, the Government said it was putting in place additional contingency plans for if the UK left the European Union without a deal.

Pharmaceutical companies who supplied NHS patients with medicines from, or via, the EU or EEA, had been asked to ensure they had a minimum of 6 weeks' additional supply in the UK, over and above their business-as-usual buffer stocks.

In a letter to pharmacists earlier this month, Dr Keith Ridge, chief pharmaceutical officer at NHS England, said that new powers would "enable community pharmacies to dispense against a protocol instead of a prescription without going back to the prescriber first".

'Not Appropriate': BMA

Commenting on the legislation, a spokesperson from the BMA said: "GPs and their teams have to contend with medicine shortages on a daily basis, much to the frustration of staff and their patients, and there are obvious concerns that a no-deal Brexit could exacerbate existing issues.

"This legislation is intended to minimise disruption to patients, GPs and pharmacists in the event of a serious shortage, building on how GPs and pharmacists are already working together locally to deal with current issues.

"However, we do not believe that it is appropriate for pharmacists to change patients from one drug to a different one without authorisation from an independent prescriber.

"Crucially, it is imperative that the specific details of the new rules and their practical application are developed by clinicians, and clearly communicated to doctors, patients and pharmacies."

Pharmacist Concerns

The Pharmacy Defence Association (PDA) said that while pharmacists were keen to ensure that patients would continue to receive their medicines, it had concerns about the impact on pharmacists at work.

In particular it was concerned that pharmacists would have to spend time explaining to patients and carers what alternative options existed in the event of a medicines shortage crisis.

"Employers need to make sure pharmacists are given the extra time, clearly agreed processes and appropriate supporting communications," it said in a statement.

"They must protect their employees and locums from any aggressive behaviour that could come from frustrated and concerned members of the public.

"The government has the responsibility to support employers in this, but if the government fails to do so, this in no way removes the obligation on employers to look after each employee or locum for whom they are responsible."

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