Fifty seven (48%) of the 118 respondents to a C+D poll – which ran on the C+D website from March 20-27 – said they would be happy to dispense an alternative under a government “serious shortage protocol” in the event of a national medicine shortage, without contacting the GP first.

The results come after shadow health secretary Jonathan Ashworth said “many community pharmacists do not necessarily want [the] responsibility” of dispensing alternatives without contacting a GP, during a parliamentary debate on pharmacists’ shortages powers last week.

Another 41% of respondents to C+D’s poll said their willingness to dispense would depend on the specific protocol, while around one in 10 respondents (11%) said they would never be comfortable dispensing an alternative quantity, dose, form or therapeutic equivalent without consulting the GP.

“Contacting the GP slows everything down”

Nat Mitchell, pharmacist and director of JWW Allison pharmacy in Cockermouth, Cumbria, said: “As long as the guidance we had to follow was robust and evidenced, I’d be happy to follow it if needed.

“It is frustrating when we aren’t allowed to substitute a dosage form, or double an available strength when the prescribed strength or form aren’t available without obtaining a new prescription,” he added.

Mr Mitchell pointed out that having to go back to the GP slows everything down and causes headaches for GPs, pharmacists and the patient.

Paul Summerfield, a locum pharmacist based in West Yorkshire, said: “Providing I was confident and was not going outside my ‘sphere of competence’ then I would be happy to” dispense an alternative.

Ali Sparkes, director of the Health Dispensary in Neath, Wales, said she would have “no qualms” dispensing an alternative under a government protocol, “as long as we were legally entitled to”.

“With the shortages we’ve been enduring we’re doing it anyway, albeit with the GPs agreement,” she added.

“Depends on the circumstances”

Daniel McNulty, a pharmacist in Lincolnshire, said he would be happy to “use [his] professional expertise to supply alternative products” as long as current indemnity insurance covers pharmacists and they are recompensed for their services and the product supplied.

“If I'm saving GP time and resources, then that needs to be reflected in the payment,” he said.

Bhavisha Patel, a locum pharmacist based in Berkshire, England, said: “When it comes to a particular strength of medication being out of stock, I would be more than willing to dispense the same medicine in an alternate strength and make up the dosage accordingly.”

But she would not be comfortable giving out another medicine without consulting the doctor and would work to liaise with the prescriber to discuss the options. 

“Even though pharmacists are the experts in medication, we are not prescribers, and therefore we need to work alongside other healthcare professionals in order to ensure the health of our patients are not compromised,” she said.

“Pharmacists are already overstretched”

Rifat Asghar-Hussain, owner of three pharmacies across England, said she would only be happy to dispense an alternative form of medicine; for example, tablets instead of capsules.

“To follow a protocol would mean extra work for us overstretched pharmacists,” she warned.