National Pharmacy Association



Pharmacy name and addressSOP prepared by (full name and role)SOP reviewed by (full name and role)SignatureSignatureDate SOP preparedSOP reviewed dateSOP version numberSOP version numberScopeThis SOP sets out the process for conducting legal and clinical checks of prescriptionsThis SOP does not cover:Other aspects of the dispensing process – refer to relevant SOPConducting legal and clinical checks of veterinary prescriptions – refer to the relevant SOPGuidanceIMPORTANT: The RP must be signed in to be able to undertake a legal and clinical check of a prescriptionRefer to the “delegation of responsibilities” notes to ensure that for each action/activity to be delegated, it takes into account the competency of the relevant team member to carry out that action/activityRefer to the relevant NPA resources and guidance documents for checking the legal requirements for prescriptions, including EEA prescriptions — available from the NPA website SOPs sectionLegal checkNHS and private prescriptions are valid for 6 months NHS and private prescriptions for Schedule 2, 3 or 4 Controlled Drugs (CDs) are valid for 28 daysPrivate repeat prescriptions are legally valid until either all repeats have been dispensed or in accordance with the prescriber’s directions as long as the initial dispensing occurs within 28 days of the appropriate date for Schedule 4 CDs and six months for other itemsHowever, it may not always be clinically appropriate to dispense outstanding repeats if a significant period of time has elapsed since the prescription was issued as the patient’s health may have changed; the prescriber should be contacted to verify if the prescribed item is still clinically suitable for the patient Ensure the prescriber is entitled to prescribe the item(s) on the presenting prescription form (NHS/private), by checking their registration entry on the relevant regulatory body website:Dentists: Doctors: .ukNurses and midwifes: .ukOther: hcpc-uk.co.uk EEA and Swiss prescribers: The General Medical Council (GMC) and General Dental Council (GDC) have contact details of equivalent EEA regulatory bodies on their websiteClinical checkThe clinical assessment should be conducted before the accuracy check. Check the patient’s suitability for the prescribed treatment using appropriate sources; for example, PMR, Summary Care Record (SCR), speak with the patient etc.When making the clinical assessment, take the following into consideration to determine the appropriateness of item(s) prescribed for patient’s condition:Specific patient groups, including children, elderly, pregnant/breastfeeding women, immunocompromised or palliative care patientsPresence of concomitant disease, for example, renal and/or hepatic impairment that may require dose adjustmentsKnown allergies, dietary intolerances, personal preferences or requirements due to religious beliefsContraindications and special warnings for useInteractions, including other prescribed or over-the-counter item(s),herbal remedies, supplements, or products purchased onlineItem(s) particulars, such as dose, form, administration route, quantity prescribed For high risk medicines, such as anticoagulant therapy, insulin, methotrexate or lithium, refer to the relevant patient safety SOPsUse appropriate references to obtain clinical information; these may include:Summary of Product Characteristics – available via the eMC website (.uk) or the Medicines & Healthcare products Regulatory Agency (MHRA) website (.uk/spc-pil)The British National Formulary (BNF) and The British National Formulary for Children (BNFC)NICE Clinical Knowledge Summaries (CKS) guidelinesExternal reference sources, for example, the NPA Pharmacy Services team on 01272 891 800Prescription interventionsIn circumstances where the prescription is not clinically appropriate to dispense, and an intervention is made, record the actions taken / advice given / interventions and referrals made where considered clinically appropriate – it is a contractual requirement to make these records in England and Wales Consider the potential for an Intervention Medicine Use Review (MUR) if appropriate – refer to relevant MUR SOPSuspicion of fraudulent prescriptionIf presented with a fraudulent or suspicious prescription, do not dispense item(s) and call the prescriber to confirm if it is genuine; if prescription is not genuine, retain prescription and inform relevant authorities and follow advice givenRefusal to supply NHS prescriptionsPharmacists can only refuse to supply an NHS prescription in accordance with their NHS Terms of Service, for example, the person presenting the prescription threatens or subjects pharmacy staff with violence, or commits or threatens to commit a criminal offenceDisallowedCheck that the prescription complies with legal requirementsConfirm the prescription is genuineInform patient/ representative of the reason why the prescription cannot be dispensedInform patient/ representative of the reason why the prescription cannot be dispensed Confirm whether the treatment is appropriate for the patient - PConfirm whether the treatment is appropriate for the condition - PAny drug-drug interactions and drug-disease interactions - PConsult the patient first as they may be able to provide clinically relevant informationInform the patient/representative that there may be a delay in dispensing the prescriptionTake steps to obtain additional information and contact the prescriber where necessaryAny potential for misuse due to excessive prescribing - PConfirm the item(s) is/are allowed on the form Refer to relevant dispensing SOPRefer the patient or representative back to the prescriber or liaise with the prescriber directlyContact prescriber to confirm if genuine if suspected that the prescription is fraudulent Complete a pharmacy Referral & Intervention form Does not complyYesYesNoYesClinicallyappropriateClinicallyappropriatePatient agreesNo appropriateNoNoComplies NHSprescriptionPrivate prescriptionAllowedNoYes ................
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