The National Health Service (Pharmaceutical Services) (General Medical Services) and (Charges for Drugs and Appliances) Amendment Regulations 2003

PART II AMENDMENT OF THE NATIONAL HEALTH SERVICE (GENERAL MEDICAL SERVICES) REGULATIONS 1992

Amendment of regulation 2

11.  In regulation 2 (interpretation), in paragraph (1)—

(a) after the definition of “assistant” insert the following definition—

““batch issue” means a form provided by a Primary Care Trust and issued by a doctor at the same time as a repeatable prescription to enable a chemist to receive payment for the provision of repeat dispensing services, which is in the format specified in Part 2 of Schedule 6B, and which—

(a)

is generated by a computer and not signed by a doctor;

(b)

relates to a particular repeatable prescription and contains the same date as that prescription;

(c)

forms part of a sequence of batch issues, the number of batch issues being equal to the number of occasions on which the drugs or appliances ordered on the repeatable prescription may be provided, and

(d)

specifies a number denoting its place in the sequence referred to in paragraph (c)”; and

(b) after the definition of “relevant service” insert the following definitions—

““repeat dispensing services” means pharmaceutical services or local pharmaceutical services which involve the provision of drugs or appliances by a chemist in accordance with a repeatable prescription;

“repeatable prescribing doctor” shall be construed in accordance with regulation 33A(1);

“repeatable prescribing list” shall be construed in accordance with regulation 33A(9);

“repeatable prescribing services” means general medical services which involve the prescribing of drugs or appliances on a repeatable prescription;

“repeatable prescription” means a prescription contained in a form provided by a Primary Care Trust and issued by a doctor to enable a person to obtain pharmaceutical services or local pharmaceutical services, which is in the format specified in Part 1 of Schedule 6B, and which—

(a)

is generated by a computer but signed by a doctor; and

(b)

indicates that the drugs or appliances ordered on that form may be provided more than once, and specifies the number of occasions on which they may be provided;”.

Amendment of regulation 4

12.  In regulation 4 (medical list), in paragraph (4), after sub-paragraph (c) insert—

“(ca) if he is included in the repeatable prescribing list;”.

Insertion of regulation 33A

13.  After regulation 33 (obtaining minor surgery services), insert the following regulation—

“Repeatable prescribing services

33A.— (1) Subject to paragraphs (7) and (8), a doctor may provide repeatable prescribing services to any person on his list of patients if that doctor—

(a) satisfies the conditions in paragraph (2); and

(b) has notified the Primary Care Trust of his intention to provide repeatable prescribing services in accordance with paragraphs (3) and (4),

and a doctor who satisfies the requirements of sub-paragraphs (a) and (b) is referred to in these Regulations as a repeatable prescribing doctor.

(2) The conditions referred to in paragraph (1)(a) are—

(a) the doctor is included in the medical list of a Primary Care Trust specified in Schedule 6A;

(b) the doctor has access to computer systems and software which enable him to issue repeatable prescriptions and batch issues;

(c) the doctor is not participating in a pilot scheme on the use of electronic prescribing as described in paragraph 1A of Schedule 2(1); and

(d) the practice premises is located in a Primary Care Trust’s area in which there is also located the premises of at least one chemist who has undertaken to provide, or has entered into an arrangement to provide, repeat dispensing services.

(3) The notification referred to in paragraph (1)(b) is a notification, in writing, by a doctor to the Primary Care Trust in whose medical list he is included, that the doctor—

(a) wishes to provide repeatable prescribing services;

(b) intends to begin to provide those services from a specified date; and

(c) satisfies the conditions in paragraph (2).

(4) The date specified by a doctor pursuant to paragraph (3)(b) must be at least one week after the date on which the Primary Care Trust receives the notification specified in paragraph (3).

(5) A doctor may not provide repeatable prescribing services unless—

(a) he is a repeatable prescribing doctor; or

(b) he is acting on behalf of a repeatable prescribing doctor pursuant to paragraph 19 of Schedule 2.

(6) Nothing in this regulation requires a doctor to provide repeatable prescribing services to any person.

(7) A doctor may provide repeatable prescribing services to a person on a particular occasion only if—

(a) that person has agreed to receive such services on that occasion; and

(b) the doctor considers that it is clinically appropriate to provide such services to that person on that occasion.

(8) A doctor may not provide repeatable prescribing services to any patient of his to whom he is authorised or required by the Primary Care Trust under regulation 20 of the Pharmaceutical Regulations to provide pharmaceutical services.

(9) A Primary Care Trust must maintain a list, in these Regulations referred to as a repeatable prescribing list, of the names of those doctors included in its medical list who are repeatable prescribing doctors.”.

Amendment of Schedule 2

14.—(1) Schedule 2 (terms of service for doctors) is amended as follows.

(2) In paragraph 1 (interpretation), in the definition of “prescription form”, at the end insert “and does not include a repeatable prescription;”.

(3) In paragraph 19—

(a) in sub-paragraph (2), for “sub-paragraphs (3), (5) and (6)” substitute “sub-paragraphs (3), (5), (6) and (6A)”; and

(b) after sub-paragraph (6) insert—

“(6A) In the case of repeatable prescribing services, a repeatable prescribing doctor shall not arrange for the provision of such services by any person who is not a doctor.”.

(4) In paragraph 40, after “prescription” insert “or repeatable prescription”.

(5) In paragraph 42, after “prescription” insert “or repeatable prescription”.

(6) In paragraph 43 (prescribing)—

(a) in sub-paragraph (1)—

(i) after “prescription form”, in the first place it appears, insert “or a repeatable prescription”, and

(ii) for “such a form” substitute “such a prescription form or repeatable prescription”;

(b) after sub-paragraph (1) insert—

“(1A) A doctor may order drugs or appliances on a repeatable prescription only where the drugs or appliances so ordered are to be provided more than once.”;

(c) in sub-paragraph (2)—

(i) after “prescription form”, in both places, insert “or repeatable prescription”,

(ii) for “the form”, in both places, substitute “the prescription form or repeatable prescription”, and

(iii) in paragraph (a), for “prescription”, in both places, substitute “prescription form or repeatable prescription”;

(d) in sub-paragraph (3), for “Misuse of Drugs Regulations 1985 (controlled drugs to which regulations 14, 15, 16, 18, 19, 20, 21, 23, 25 and 26 of those Regulations apply)”, substitute “Misuse of Drugs Regulations 2001 (controlled drugs to which regulations 14, 15, 16, 18, 19, 20, 21, 23, 26 and 27 of those Regulations apply)”;

(e) in sub-paragraph (5)—

(i) after “prescription form”, in both places, insert “or repeatable prescription”, and

(ii) for “Misuse of Drugs Regulations 1985” substitute “Misuse of Drugs Regulations 2001”; and

(f) in sub-paragraph (6)—

(i) after “prescription form”, in both places, insert “or repeatable prescription”, and

(ii) for “Misuse of Drugs Regulations 1985” substitute “Misuse of Drugs Regulations 2001”.

(7) After paragraph 43 insert—

“Repeatable prescribing services

43A.— (1) A doctor who issues a repeatable prescription must at the same time issue the appropriate number of batch issues.

(2) A doctor who has provided repeatable prescribing services to a person must, as soon as is practicable, notify that person, and make every effort to contact the chemist providing repeat dispensing services to that person, if—

(a) he makes any change to the type, quantity, strength or dosage of drugs or appliances ordered on that person’s repeatable prescription; or

(b) he considers that it is no longer appropriate or safe for that person to receive the drugs or appliances ordered on his repeatable prescription, or no longer appropriate or safe for him to continue to receive repeatable prescribing services.

(3) If a doctor provides repeatable prescribing services to a person in respect of whom he has previously issued a repeatable prescription which has not yet expired (for example, because that person wishes to obtain the drugs or appliances from a different chemist), the doctor must make every effort to notify the chemist which has in its possession the repeatable prescription which is no longer required.

(4) If a doctor has issued a repeatable prescription in respect of a person, and (before the expiry of that repeatable prescription) that person is removed from that doctor’s list of patients, that doctor must—

(a) notify that person; and

(b) make every effort to notify the chemist who has been providing repeat dispensing services to that person,

that the repeatable prescription should no longer be used to obtain or provide repeat dispensing services.”.

(8) In paragraph 44—

(a) after “prescription form”, in each of the places it appears, insert “or repeatable prescription”; and

(b) after sub-paragraph (3) add—

“(4) In the course of treating such a patient a doctor shall not order on a repeatable prescription a controlled drug within the meaning of the Misuse of Drugs Act 1971, other than a drug which is for the time being specified in Schedule 4 or 5 to the Misuse of Drugs Regulations 2001, but may otherwise prescribe such a drug for that patient in the course of that treatment.”.

(9) In paragraph 46, for “paragraphs 43 and 44” substitute “paragraphs 43, 43A and 44”.

(10) In paragraph 49 (inquiries about prescriptions and referrals), in sub-paragraph (1)(a), after “prescription form” insert “or repeatable prescription”.

Insertion of Schedules 6A and 6B

15.  After Schedule 6 (minor surgery procedures), the following Schedules shall be inserted as Schedules 6A and 6B—

Regulation 33A

“SCHEDULE 6A PRIMARY CARE TRUSTS SPECIFIED FOR THE PURPOSES OF REPEATABLE PRESCRIBING

• Amber Valley Primary Care Trust

• Bebington and West Wirral Primary Care Trust

• Birkenhead and Wallasey Primary Care Trust

• Blackburn with Darwen Primary Care Trust

• Bristol North Primary Care Trust

• Bristol South and West Primary Care Trust

• Bromley Primary Care Trust

• Burnley Pendle and Rossendale Primary Care Trust

• Central Cornwall Primary Care Trust

• Charnwood and North West Leicestershire Primary Care Trust

• Cheltenham and Tewkesbury Primary Care Trust

• Coventry Primary Care Trust

• Durham and Chester-le-Street Primary Care Trust

• Durham Dales Primary Care Trust

• East Elmbridge and Mid Surrey Primary Care Trust

• East Leeds Primary Care Trust

• Eastern Birmingham Primary Care Trust

• Erewash Primary Care Trust

• Gateshead Primary Care Trust

• Great Yarmouth Primary Care Trust

• Newbury and Community Primary Care Trust

• Newham Primary Care Trust

• North Birmingham Primary Care Trust

• North Hertfordshire and Stevenage Primary Care Trust

• Northumberland Primary Care Trust

• Portsmouth City Primary Care Trust

• Preston Primary Care Trust

• Sheffield West Primary Care Trust

• South East Sheffield Primary Care Trust

• Suffolk Coastal Primary Care Trust

• Taunton Deane Primary Care Trust

• Western Sussex Primary Care Trust.

Regulation 2(1)

SCHEDULE 6B REPEAT DISPENSING FORMS

PART 1 REPEATABLE PRESCRIPTION

PART 2 BATCH ISSUE

”.

Amendment of Schedule 12

16.  In Schedule 12 (information to be included in practice leaflets), after paragraph 10 insert—

“10A.   If the doctor is a repeatable prescribing doctor, the arrangements for providing repeatable prescribing services.”.

Amendment of Schedule 13

17.  In Schedule 13 (information to be provided in annual reports), after paragraph 2 insert—

“2A.   If the doctor is a repeatable prescribing doctor, the arrangements for providing repeatable prescribing services.”.

(1)

Paragraph 1A of Schedule 2 was inserted by S.I. 2001/2890.