How would you approach a script with a suspicious amendment?

Until the script can be verified as being correct, the medicine should not be dispensed. If the prescriber confirms the ammendment is false, then keep the script as evidence, report the script to the local PCT as being forged - and the patient will have to see his/her doctor for a legal RX.

Hi i think reporting to the police is a little severe and jumping the gun.

You must tell the patient you need to confirm the Rx with the GP, and need to await their reply. Don't need to explain what the query is. Ask them to come back later. If the Rx is forged
1- do not dispense Rx as ilegal
2- leave it to the physician to decide the course of action.
3- advise pt to see GP
4 The Rx should be kept as evidence for primary care trust.

1. Explain to the patient that we have to confirm something with the doctor - if they ask then explain its the amendment and that some changes need confirming as its good professional practice.
2. If patient is desperate and the original dr can't be contacted without delay then perhaps dispense the original amount i.e. 6 not 60 and explain that we will contact her once we have spoken to prescriber.
3. Once dr has called and it is a fraud case then retain prescription. It would be upto the doctor to decide next action.

For those above who would have supplied 6 tablets, if you have been informed that the prescription has been altered, then the whole prescription is invalid and if you make any supply you have just broken the law as you have supplied a POM not in accordance with a legal prescription.

The dr should become involvd but only to inform them that their patient has potentially altered a prescription. Once there has been confirmation that the Px has been altered and that the alteration was not by the prescriber, then the correct action is as David Wayles has stated - involvement of the PCT and the police - no hesitation.

Section 2 Fraud Act 2006 clear makes this an offence as it is fraud by false representation. In the alternative it as a S3 Forgery and Counterfeiting Act 1981 offence or to go down the Theft Act 1968 route, it was a Section 15 offence until the Fraud Act 2006 came along.

The PCT could be informed by involvement of the NHS Counter Fraud team - I would recommend that they are contacted in the first instance as they are very very good at what they do. As the original document will be required by the police and normally seized as evidence, so take a photocopy for use by the PCT / NHS SMS.

There is a whole "confidential info" issue but a serious crime (Fraud) has been committed against a public body (the NHS) and therefore, providing you get something from the police stating that they require the information for the prevention and detection of crime AND you release only the information required for such, you will not be in breach of any confidentiality obligation. In this case, the information would be visible on the Px as the name and address, DOB etc. Do not release any other info such as previous Px's, medication records etc as that would be a clear breach of going over and above what was needed.

In relation to the Pharamcy Reward Scheme, David is again correct in that it is the contractor who receives the payment and not the practitioner. Getting the £70 or so from the contractor can be very difficult. As I am not an employee then I could not comment on how employees get the reward from their employer but as a locum, invoice the contractor for it and make a note of it.