Keats Pharmacy in Hampstead, north London, has a policy that gives some patients the option to pay additional money on top of the NHS prescription charge of £9.35, practice manager David Harvey told C+D on Wednesday (May 4).
In these cases, the patient is offered the option to pay a small fee to ensure the pharmacy breaks even on dispensing certain items, with no aim of making a profit on these transactions, he explained.
However, the NHSE&I team in London told C+D that pharmacies cannot charge more than the “current prescription charge”.
“This issue is being reviewed in accordance with relevant National Health Service Regulations, and further action will be taken if required,” they added.
The General Pharmaceutical Council (GPhC) looked into a complaint raised by a patient about the pharmacy’s policy and decided to close the case (read more about the GPhC’s decision below).
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Keats Pharmacy’s policy explained
Mr Harvey explained that, when a patient presents an NHS prescription for which the pharmacy knows it will “incur a dispensing loss”, the patient is presented with some options.
Having checked that the patient has enough supply of the medicine, they would be asked if they can wait to collect the medication at the end of the month, when concessionary prices are published.
Alternatively, the financial “difficulty faced by the pharmacy through the reimbursement policies” would be explained and the patient would be asked if they “would like to pay the difference between loss and break-even on the NHS Drug Tariff”.
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“These situations only occur occasionally and often the medication is out of stock from the wholesalers anyway. There again, sometimes we are able to supply from stock we have bought previously at below Drug Tariff price,” Mr Harvey told C+D.
But he specified that if the patient does not have an adequate supply of the medication and the pharmacy has it in stock, then a supply will be made to the patient, even if that means incurring a loss for the pharmacy.
Why is the pharmacy’s policy being reviewed?
A patient reported Keats Pharmacy to the GPhC in February, after a staff member allegedly asked them to “make up the difference” for his blood pressure medication when he went to collect it, local publication Ham&High reported earlier this week.
According to the patient, the staff member told them that NHS reimbursement would not fully cover the cost of ordering the Atenolol, so “it would not be viable for her to order the drug” unless they covered what the pharmacy would lose on his prescription.
Susan Hunneyball, partner at Gordons Partnership law firm, told C+D that pharmacies “must provide the drugs that are ordered with reasonable promptness”.
In this specific case, the pharmacist supplying the medicine may be in breach where they are in a position to supply, but refuse to do so to wait until price concessions come out, Ms Hunneyball explained.
But Mr Harvey said that this is not the case. If a patient refuses to pay for the difference between the medicine’s price in the Drug Tariff and the price paid by the pharmacy, but they must have a supply of the medication, then they would be provided with this, even though it “may then cause a loss to the pharmacy”.
GPhC investigation into pharmacy “closed”
The Ham&High reported that the GPhC had responded to the patient's complaint on March 30, informing them that Keats Pharmacy had “apologised” – citing issues with supply of Atenolol – and that their outstanding medication was ready to collect.
“We are of the view that the pharmacy has taken the appropriate action and there is no further action required by the GPhC from a regulatory perspective,” it reportedly told the patient via email.
A GPhC spokesperson told C+D that it had “dealt with the concern when it was raised directly with [it]” earlier this year, but that “the matter has since been closed”.
It has, however, kept “a record of the concern”, the spokesperson said, which will be “considered during future inspection visits or in relation to future concerns” about Keats Pharmacy.
The Department of Health and Social Care (DH) told C+D that the matter would be for NHSE&I to investigate.
It further stressed to C+D that for an NHS prescription, a dispensing pharmacist should only apply one charge – currently set at £9.35 – for each drug supplied.