The guidance, published by the Pharmaceutical Services Negotiating Committee (PSNC) and Pharmacy Voice last Friday (August 26), comes after C+D revealed that a string of clinical commissioning groups (CCGs) in England have imposed schemes to stop pharmacies from ordering repeat prescriptions on behalf of their patients.

Several CCGs have adopted a flagship model trialled in Luton – where contractors say they have doubts that the scheme has generated the £400,000 savings that the CCG claims.

Meanwhile Cambridgeshire and Peterborough CCG, Southport and Formby CCG and Sefton CCG have all rolled out similar schemes, which have split C+D readers’ opinions.

PSNC and Pharmacy Voice said contractors “are concerned about the unintended consequences these changes may have on patients”. Pharmacists are worried that patients who are “vulnerable, time poor and/or require assistance" could be most impacted, the organisations said.

It is also aware that CCGs and GP surgeries “have raised concerns about medicines waste and the mismanagement of non-NHS repeat medication services", the organisations said.

Work together to increase uptake

In their guidance document, PSNC and Pharmacy Voice said there is "always scope" to "improve how [pharmacy] repeat medication services operate". This would require "local GPs and community pharmacies to work together to ensure timely and appropriate patient access to their medicines". 

“Despite the efforts of community pharmacies…uptake [of the community pharmacy repeat dispensing service] has remained very low,” the organisations said.

Pharmacies have set up alternative services to address this shortfall, and the organisations stressed that “non-NHS repeat medication services provided by community pharmacies are underpinned by robust governance systems and implemented using standard operating procedures”.

The two organisations also used their document to suggest ways to ensure repeat dispensing services are "comprehensively adopted" at a local level.

"We recommend the adoption of a collaborative approach with local pharmaceutical committees, local medical committees, local Healthwatch and patient organisations [to] determine the most appropriate measures to encourage the implementation of repeat dispensing in your area," they added.

Pharmacy Voice senior policy adviser Kim Packham said pharmacists should “refocus their efforts” on improving uptake of electronic repeat dispensing, which “will address many of the concerns that both CCGs and pharmacy teams have about the ordering and management of repeat medication”.

NHS England estimates that if 80% of repeat prescriptions were prescribed via repeat dispensing services, 2.7 million hours of general practice surgery time could be saved, the pharmacy organisations claimed. 

Think before "unpicking" services

In the meantime, CCGs that target pharmacy repeat ordering systems risk affecting patients “adversely”, warned Ms Packham, who called on CCGs to work with pharmacies to address medicines waste.

"As the current uptake of repeat dispensing is low, many pharmacies also offer a variety of services to support patients in accessing their medicines. Initiatives that unpick these services should be carefully considered and consulted on with local pharmacies, general practice and patients so that people are not adversely impacted."