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COVID-19 SOP: Pharmacists could check meds for re-use in care homes

A registered healthcare professional in the care home should normally carry out the check
A registered healthcare professional in the care home should normally carry out the check

Community pharmacists and pharmacy technicians in England could be asked to check medicines for re-use in care homes and hospices in line with a COVID-19 SOP.

  • The Department of Health and Social Care (DH) does not normally recommend the re-use of another patient’s medicine but believes such a scheme could help ease pressure on the medicines supply chain during the pandemic.
  • A registered healthcare professional in a care home or hospice would normally check if a medicine can be re-used in line with a DH and NHS England SOP on running a medicines re-use scheme in a care home or hospice setting
  • If a registered professional is not available on site, a pharmacist or pharmacy technician might be asked to carry out the check instead

Care homes and hospices deciding to run a medicines re-use scheme in line with the DH and NHS England standard operating procedure (SOP) need to ensure that, before a medicine is re-used under the scheme, they carry out a risk assessment.

This entails checking the medicine against the criteria set out in the SOP, which the DH published last week (April 28).

The guidance states that “in the first instance” a registered healthcare professional working in the care home or hospice should carry out this check.

However, should there not be such professional available “on site”, other registered healthcare professionals from “local organisations” could be asked to check if the medicine is suitable for re-use. This includes “pharmacists, pharmacy technicians, general practitioners [and] community nurses”.

Not contractually required

Community pharmacy professionals are not contractually required to carry out these checks and if they do, they must “ensure they have appropriate indemnity insurance arrangements in place”, the Pharmaceutical Services Negotiating Committee (PSNC) said last week April 29.

The DH does not normally recommend the re-use of another patient’s medicine, as the quality of a medicine can no longer be guaranteed once it leaves the pharmacy, it said the COVID-19 SOP on running a medicines re-use scheme in a care home or hospice setting.

However, “there are increasing concerns about the pressure that could be placed on the medicines supply chain during the peak of the COVID-19 pandemic” and a medicines re-use scheme for care homes and hospices could help ease some of that pressure, the DH explained.

Community pharmacy’s role

PSNC believes that pharmacies that regularly supply medicines to care homes and hospices might benefit from being aware of the DH and NHS England SOP, as “most community pharmacy teams are unlikely to come across” a medicines re-use scheme as described in the DH and NHS England SOP.

Community pharmacy is given precise instructions in the SOP regarding what action to take if participating in a medicines re-use scheme in a care home or hospice.

“When medicines are out of stock and there is an immediate need for them, an alternative preparation should be prescribed and dispensed, as is usual practice where possible,” according to the guidance.

However, if a new prescription for an alternative medicine cannot be written, “the community pharmacy team should ask the care home or hospice whether they run a medicines re-use scheme and whether they have any stock of the required medicine”, the DH said

If stock is available in the care home or hospice, the pharmacy team “must share a copy of the prescription for that medicine with the home and update the corresponding Medication Administration Record (MAR) chart as necessary”.

PSNC added that “where the care home or hospice do not have a procedure in place” to amend the MAR charts in their possession “the pharmacy could issue a new MAR chart for the product that is to be re-used”.

Have you come across a care home re-use scheme?

Paul Dishman, Pharmaceutical Adviser

Send the practice pharmacists in as they've got time on their hands as well as access to PPE

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Not contractually required = won't be doing it.

Mind you, I do think one thing that really needs addressing is the MASSIVE medicines wastage from care homes. I did an audit a couple of years ago and two care homes accounted for as much wastage to the NHS as 7000 ordinary people. If they gave the meds properly, surely there would be no unused meds to check?

Kevin Western, Community pharmacist

Let me get this straight... for years Pharmacies have been providing services to Nursing homes for free, it has now become economically marginal at best, usually a loss, They now want us to take on additional responsiblity, including liability,  to "save the nation" for diddly squat, while the GPs and their huge teams sit on their fundaments, all covid expenses garaunteed,safe behind layers of ppe and locked doors, or doing triage from their kitchen tables on NHS provided laptops, while being paid double cos they are moonlighting on NHS111.

I think there is a short phrase I can think of which sums up my attitude. 

I am sure that some voices on PSNC will say yes please just to keep the DoH sweet , because that is all that is stopping them from screwing us.

oh hang on....




Adam Hall, Community pharmacist

Get the GP based pharmacists to take the risk - I won't

O J, Community pharmacist

Sshhhhh.....just be a nice guy and follow the protocol.

N O, Pharmaceutical Adviser

Why there is NEVER a mention of the Clinical Pharmacists, who are recruited to do exactly these roles?? How can you justify their existance and the money being taken away from CP to fund this pet project of Mr. K.R.?? Are they only supposed to sit behind a desk and manage issuing of prescriptions (glorified prescription clerks)??

Why the PSNC is so silent and accept such rubbish by just mentioning Contractually not Obliged?? Are they not aware of many services we provide, despite being Contractually not Obliged to do so?

V K P, Community pharmacist

Brilliant, the pharmacy can do all task for free and be out of pocket. PSNC please send brain tumour patients and we will operate on them in our pharmacies for free. lets make it interesting. oh no brain surgeries are not part of any GP's role. but we are better than the GPs and can do what they cant do.

how much does a brain surgeon earn?? please enlighten, anyone?? 

it would be more than Mr Rudkin i reckon. He wont like that and will pull all stops to prevent the pharmacists earning more than him.


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