Pharmacists, doctors, patients call for change in law to expedite access to medicines in short supply

Pharmacists, GPs and patients have called for a change in law to reduce bureaucracy and speed up patient access to medicines in short supply.

"We are concerned about the impact that medicines shortages are having on patient care and urge you to work with GPs, pharmacists and patient groups to reduce bureaucracy and

speed up access to appropriate treatment," various pharmacy and doctors' organisations wrote in a joint letter to health secretary Matt Hancock on Friday (September 11).

"Pharmacists and GPs are having to spend more time dealing with medicines shortages, with community pharmacists legally obliged to contact prescribers or refer people back to

prescribers to amend original prescriptions, even for minor adjustments," the letter outlined.

It called on the government to amend medicines legislation to allow pharmacists to make changes to prescriptions and provide a different quantity, strength, formulation or generic version of the same medicine, if it is in short supply.

The letter also called on the government to work with stakeholders to implement the changes ahead of the end of the UK transition from the EU at the end of this year.

“We urgently need this change ahead of the triple whammy of a second wave of coronavirus, the flu season and a potential no-deal Brexit, all of which would again place heavy demands on the medicines supply chain and primary care services," said Sandra Gidley, president of the Royal Pharmaceutical Society (RPS).

"Pharmacists are experts in medicines and need greater flexibility under the law to make simple changes to prescriptions that help patients get the medicines they need when they need them. It makes no sense to have to turn patients away without their medicine when the answer could literally be sitting on the shelf.”

Currently, community pharmacists are legally obliged to contact prescribers, or refer patients back to prescribers, to amend original prescriptions even for minor adjustments such as supplying two packets of 20mg tablets if the 40mg packet prescribed is out of stock, which is frustrating for patients, pharmacists and doctors.

This causes delays in access to medicines and takes up health professionals’ time which could be better spent supporting patient care.

Chair of the Royal College of GPs (RCGP) Professor Martin Marshall said: “It can be frustrating for GPs, pharmacists and patients when prescriptions can’t be dispensed due to shortages – and that minor adjustments to prescriptions which could be dispensed can’t be made by an experienced pharmacist without being reviewed by a GP.

"Unfortunately, not only does this step increase GP workload, but often it slows down patient access to medication. Pharmacists are highly skilled in their area of expertise – medicines - so trusting them to make appropriate and sensible decisions regarding medicines, depending on supplies, will in turn allow GPs to focus on patients who need our care the most.”

The new proposal is restricted to the way a prescribed medicine is provided, rather than changes to the medicine itself.

Chair of the British Medical Association (BMA's) GP Committee Dr Richard Vautrey said: “At a time of significant increase to GP workload and the problems with supply of medications, allowing pharmacists to make these changes so that patients can obtain their medicines in a timely manner can only be a good thing for both doctors and patients.

"GP practices have to deal with a significant amount of bureaucracy which takes precious time away from seeing patients and changes like this will go some way in addressing that, especially as we head into winter and at a time when we are seeing the number of Covid cases increase again.”

The joint letter was co-signed by the RPS, the Pharmaceutical Services Negotiating Committee, Community Pharmacy Scotland, Community Pharmacy Wales, the BMA, the RCGP, National Voices, a patient group.

National Voices chief executive Charlotte Augst said: “People who use medicines have told us that they experience delays and shortages not only as an inconvenience, but that it can cause them anxiety and distress.

"Where a medicine can be safely swapped for one that is just a different package size or quantity, it is better for everyone for this option to be discussed with the patient and a shared decision to be made that enables the pharmacist to simply provide the medicine that helps the patient. Anything else just adds inconvenience and ultimately cost for no added benefit.”