SCHEDULE 4F15NHS England’sTerms of service of NHS pharmacists

Annotations:

PART 2Essential services

Refusal to provide drugs or appliances ordered9

1

An NHS pharmacist (P) may refuse to provide the drugs or appliances ordered on a prescription form or repeatable prescription where—

a

P reasonably believes that it is not a genuine order for the person named on the prescription form or the repeatable prescription (for example because P reasonably believes it has been stolen or forged);

b

it appears to P that there is an error on the prescription form or on the repeatable prescription or, in the case of a non-electronic repeatable prescription, its associated batch issue (including a clinical error made by the prescriber) or that, in the circumstances, providing the drugs or appliances would be contrary to P's (in practice, a registered pharmacist's) clinical judgement;

c

P or other persons on the premises are subjected to or threatened with violence by the person presenting the prescription form or repeatable prescription or requesting the provision of drugs or appliances in accordance with an electronic prescription form or a repeatable prescription, or by any person accompanying that person;

d

the person presenting the prescription form or repeatable prescription or requesting the provision of drugs or appliances in accordance with an electronic prescription form or a repeatable prescription, or any other person accompanying that person, commits or threatens to commit a criminal offence; or

e

the prescription form or repeatable prescription is incomplete because it does not include the information relating to the identification of the prescriber that F15NHS England (or a person exercising its functions) requires in order to perform its functions relating to—

i

the remuneration of persons providing pharmaceutical services, and

ii

any apportionment of, or any arrangements for recharging in respect of, that remuneration,

unless P (or the person who employs or engages P) is to receive no pharmaceutical remuneration of any kind in respect of the drug or appliance.

2

P must refuse to provide a drug ordered on a prescription form or repeatable prescription where the order is for a prescription only medicine which the prescriber was not entitled to prescribe.

F12A

P may refuse to provide a drug or appliance ordered on an electronic prescription if the access that P has to the Electronic Prescription Service is not such as to enable P to dispense that prescription promptly (or at all) F3, but where P does so, P must take all reasonable steps to ensure that the product ordered by the prescriber is supplied within a reasonable timescale, which may include (depending on what steps or combination of steps the circumstances require)—

a

providing details of other NHS pharmacists or LPS chemists whose premises are situated in the same area and who may be able to provide the product ordered by the prescriber;

b

urgent supply without a prescription in accordance with paragraph 6;

c

arranging for the urgent provision of a non-electronic prescription form by the prescriber.

F22B

P must refuse to provide a drug or appliance ordered on a prescription form or a repeatable prescription where—

a

a SSP has effect in respect of—

i

the requested drug or appliance, or

ii

drugs or appliances of a specified description, and the requested drug or appliance is of that description; and

b

alternative provision has already taken place in accordance with the SSP.

2C

P may refuse to provide a drug or appliance ordered on a prescription form or a repeatable prescription where—

a

a SSP has effect in respect of—

i

the requested drug or appliance, or

ii

drugs or appliances of a specified description, and the requested drug or appliance is of that description;

b

a registered pharmacist is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity of product to that ordered by the prescriber is unreasonable or inappropriate; and

c

P is unable to provide the drug or appliance within a reasonable timescale,

but if P does refuse to do so, P must provide the patient or the person requesting the drug or appliance on behalf of a patient with appropriate advice, as necessary, about reverting to the prescriber for the prescriber to review the patient’s treatment.

3

P must refuse to provide drugs or appliances ordered on a repeatable prescription where—

a

P has no record of that prescription (other than on the first occasion on which the prescription is presented);

b

P does not, in the case of a non-electronic repeatable prescription, have any associated batch issue and it is not presented to P;

c

it is not signed by a prescriber;

d

to do so would not be in accordance with any intervals specified in the prescription;

e

it would be the first time a drug or appliance had been provided pursuant to the prescription and the prescription was signed (whether electronically or otherwise) more than 6 months previously;

f

the repeatable prescription was signed (whether electronically or otherwise) more than one year previously;

g

the expiry date on the repeatable prescription has passed; or

h

P has been informed by the prescriber that the prescription is no longer required.

4

Where a patient requests the supply of drugs or appliances ordered on a repeatable prescription (other than on the first occasion that the patient makes such a request), P must only provide the drugs or appliances ordered if P is satisfied—

a

that the patient to whom the prescription relates—

i

is taking or using, and is likely to continue to take or use, the drug or appliance appropriately, and

ii

is not suffering from any side effects of the treatment which indicates the need or desirability of reviewing the patient's treatment;

b

that the medication regimen of, or manner of utilisation of the appliance by, the patient to whom the prescription relates has not altered in a way which indicates the need or desirability of reviewing the patient's treatment; and

c

there have been no changes to the health of the patient to whom the prescription relates which indicate the need or desirability of reviewing the patient's treatment.

F45

P may refuse to F5fulfil an order or a request for a drug that is or is purportedly in accordance with F11a LPIV, a PTP F6or a PTPGD where—

a

P reasonably believes it is not a genuine order F10or valid request for the person who requests, or on whose behalf is requested, the provision of the drug;

b

providing it would be contrary to P’s clinical judgement;

c

P or other persons are subjected to or threatened with violence by the person who requests the provision of the drug, or by any person accompanying that person; or

d

the person who requests the provision of the drug, or any person accompanying that person, commits or threatens to commit a criminal offence.

6

P must refuse to provide, pursuant to F12a LPIV, a PTP F7or a PTPGD, an order F8or a request for a drug that is or is purportedly in accordance with F13the LPIV, the PTP F9or PTPGD where P is not satisfied that it is in accordance with F13the LPIV, the PTP F9or PTPGD .

F147

P may refuse to provide a prescription item ordered on a prescription form or repeatable prescription where—

a

more than one prescription item has been ordered on the prescription form or repeatable prescription;

b

at least one of those prescription items is a listed HRT prescription item and at least one of those prescription items is not; and

c

the person named on the prescription form or repeatable prescription is claiming entitlement to exemption under regulation 10(1)(j) of the Charges Regulations (exemptions) in respect of any of those prescription items which is a listed HRT prescription item.