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Community Pharmacy Briefing: When patients need repeat medication out of hours START HERE Patient needs supply of repeat medications, e.g. has come on holiday and forgotten to bring their medicines has forgotten to order routine medication in good time CHECK – does patient really need to obtain the medicine(s) urgently? For example, if it is the weekend, what supply of medicines do they have left; will it wait until a weekday? EMERGENCY SUPPLY AT THE REQUEST OF A PRESCRIBER Can the patient make contact with their home GP to arrange for them to fax/post a prescription to the pharmacy? OPTION 1 EMERGENCY SUPPLY AT THE REQUEST OF A PATIENT Can the medications requested be provided by an emergency supply? Remember there are specific conditions for emergency supply, i.e.: Patient is present in person Patient can provide details of normal GP and/or evidence the medicines requested are prescribed regularly (for example repeat slip, labelled boxes) Supplies of schedule 1, 2 or 3 controlled drugs are NOT permitted Charging arrangements are as per the pharmacy’s own policy. THE PHARMACIST CAN ACCESS MEDICAL ADVICE OPTION 2 OPTION 3 Pharmacists can call ….. in case of emergency only. This allows them to access a health professional through the OOH service and which may be used for genuinely urgent medication requests, for example medicines urgently needed for epilepsy, diabetes or respiratory disease. It is important that this number is restricted to pharmacist use only. Patients should not use this number as they would not be able to get appropriate assistance. If the patient is a Dorset resident, advise them of the appropriate measures that may assist them in preventing this happening again, eg repeat dispensing, managed repeats, and ordering prescriptions in plenty of time INAPPROPRIATE SIGNPOSTING Please remember that it is not appropriate to signpost patients seeking repeat medications to the Out Of Hours service or to local MIU or A&E departments. Correct at June 2013 – Please refer to the most up to date copy of the MEP. CHECKLIST FOR PROVISION OF AN EMERGENCY SUPPLY AT THE REQUEST OF THE PATIENT (ADAPTED FROM MEDICINES ETHICS AND PRACTICE) This checklist is provided as a reminder for Dorset pharmacies. The responsible pharmacist should be aware of the most recent legislation when deciding whether and emergency supply is appropriate. Criteria Tick Patient is present in person (may be interviewed by telephone in exceptional circumstances) Inform patient that if an emergency supply is possible, that the service is not free, patient will be asked to pay for the medicine(s) required Patient has previously been prescribed the medicines requested by a: UK doctor UK supplementary prescriber UK dentist UK optometrist independent prescriber UK nurse independent prescriber UK pharmacist independent prescriber UK community nurse practitioner OR European Economic Area (EEA*) doctor or dentist ** Swiss doctor or dentist** There is an immediate need for the medicines to be supplied AND the time interval from when the medicine was last used to the time of requesting an emergency supply has been considered (referral to prescriber may be necessary) Patient has proof of medicines prescribed (e.g. copy of repeat list or labelled box) If patient has no proof of medicines supplied, can the patient supply details of their GP, for the purpose of obtaining details of regularly prescribed medication? None of the drugs to be supplied are in controlled drug schedules 1, 2 or 3*** If any of the drugs to be supplied are in controlled drug schedules 4 or 5, you are satisfied that supply of these drugs is appropriate, and there is no risk of misuse or diversion The dose and frequency of the drugs to be supplied is clear Appropriate supply is provided (no more than 30 days except for insulin, cream/ointment, and inhalers, where smallest pack available should be supplied, and oral contraceptives, where a full cycle should be provided). Appropriate records of the supply are made: Date of supply Name and address of patient Quantity of medicine(s) supplied Nature of emergency Name, strength and form of medicine(s) supplied Please follow your pharmacy SOP for making records of the supply. “Emergency Supply” has been added to the label of medicine(s) supplied ** requests made by a patient of an EEA or Swiss doctor/dentist cannot be supplied if they are for medicines that do not have a marketing authorisation in the UK. *** except in cases of phenobarbital for epilepsy, for patients registered with a UK prescriber. Correct at June 2013 – Please refer to the most up to date copy of the MEP. *List of EEA countries: Austria Estonia Iceland Luxembourg Romania Belgium Finland Ireland Malta Slovakia Bulgaria France Italy Netherlands Slovenia Cyprus Germany Latvia Norway Spain Czech Republic Greece Liechtenstein Poland Sweden Denmark Hungary Lithuania Portugal United Kingdom Correct at June 2013 – Please refer to the most up to date copy of the MEP.