Ordinarily, a pharmacy owner must supply a prescribed product with reasonable promptness. However, if the prescribed product is the subject of a SSP:
- the pharmacy owner must consider whether it is reasonable and appropriate to supply in accordance with the SSP instead of in accordance with the prescription and may refuse to supply what is on the prescription
- the pharmacy owner may provide a different product or different quantity to what is prescribed if:
- this can be done with reasonable promptness;
- it is in accordance with the SSP; and
- the supply is by or under the direct supervision of a pharmacist who is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity is reasonable and appropriate.
If a supply is made under an SSP:
- prescriptions must be endorsed appropriately for remuneration purposes
- pharmacy owners must notify prescribers of a supply under a SSP, if the Department of Health and Social Care has published a recommendation to do so
- patients must be informed of the different supply by including information on the dispensing label.
If an SSP is in place, pharmacy owners do not have to use it. If a pharmacy owner is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity is unreasonable or inappropriate and they are able to supply the prescribed product or quantity within a “reasonable timescale”, they are allowed to do this and no longer have to supply with “reasonable promptness”.
We can assume that “reasonable timescale” involves a longer period than “reasonable promptness”, but the actual period in either case would necessarily depend on the precise facts and circumstances.
Similarly, if a pharmacist is of the opinion that supplying a different product or quantity under a SSP is unreasonable or inappropriate, and is unable to provide a different product within a reasonable timescale, a supply under the SSP can still be refused. In this case, the patient must be referred back to the prescriber.
We can only hope that the feared shortages – whether resulting from a no-deal Brexit or not – do not materialise, and that despite all the effort in changing the law to allow SSPs, they are never needed.
David Reissner is chair of the Pharmacy Law and Ethics Association