• 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”.