Community Pharmacy England (CPE) has announced that it is “broadly supportive” of the government consultation on enabling pharmacist flexibilities to make substitutions when dispensing medicines.
But it said that the proposals “do not go far enough” – including around generic substitution - and that it disagrees “with the proposed implementation approach”.
Read more: IN FULL: DH launches consultation on substitutions
In its draft response published last week (October 23), the negotiator said that the ability to use flexibilities “should be the norm unless specifically prohibited when described in a serious shortage announcement”.
“There is already a proven and working system for pharmacists in Scotland and this is what we would like to see replicated across England,” it added.
CPE argued that while it recognises the need to “provide restrictions and safeguards around the introduction of flexibilities”, it encourages the legislation “to be made as broad as possible”.
Read more: A line in the sand: the unexplained exclusion of generic substitution
It called for patients to be able to “access a generic medication in a case when a branded generic has been prescribed and is not readily available” in cases of “urgent need”, suggesting that this would “further reduce the burden on prescribers”.
The negotiator would like to see “further expansion of the scope of the current proposals to include the supply of medications where the active ingredient remains the same”, it added.
Assess pharmacy “workloads”
CPE’s draft response also called for “an assessment of pharmacy team workloads associated with the use and auditing of any implemented flexibilities” to ensure the sector is “sufficiently remunerated for its work for the NHS”.
“Community pharmacies should not be economically disadvantaged from making these changes for patients,” it stressed.
While increased pharmacist powers should reduce GP workloads and costs, “there are additional costs, both explicit and implicit, for a pharmacy associated with a supply that is different from the original prescription”, it said.
Read more: DH launches policy paper on pharmacist drug substitutions
It also highlighted that the government proposal is “absent on the requirement” for patients to “consent to a change in their medication”.
It argued that patients should be “central to any change in the supply stated on the prescription” and should provide their consent verbally for recording by the pharmacy team.
The negotiator, however, said that it disagrees with the need to “notify the prescriber” if a pharmacist has “utilised” the flexibilities to supply an alternative medicine.
Read more: ‘Significant disappointments’: DH rejects generic substitution recs
It comes after the government finally launched the much-anticipated consultation last month - due to run until December 11.
National Pharmacy Association (NPA) chair Olivier Picard welcomed the proposals at the time but stressed that “any changes introduced must be simple and provide genuine flexibility to pharmacists”.
And Company Chemists’ Association (CCA) chief executive Malcolm Harrison argued that while it would “improve patient experience and outcomes”, the reforms would not “resolve the issue of national medicine shortages”.
