Here's a basic idea for anyone interested enough to know what goes into dispensing a prescription. That's before whatever they need to do to get paid for filling the prescriptions. For those who mentioned the methodone clients getting served first - I think given the behaviour of most of them I'd let them go before me to so as to get rid of them.Follow normal procedure as per SOP (enter title and number) with the following
additions :
• Check that the repeatable prescription is computer-generated
• Check that the GP has signed the repeatable prescription as this is the legal
prescription under the Medicines Act
• Check that the repeatable prescription is in date (it must be dispensed for the first
time within six months of being issued)
• Check the repeatable prescription states the number of issues authorised (up to
12)
• Check that there are the correct number of batch issues to match the number of
issues authorised
• Check the number of batch issues and their likely validity over time (batch issues
can only be dispensed during the time that the master repeatable prescription is
valid – 12 months from the date of issue)
• Check that the necessary information is present (e.g. directions and quantity) to
enable the dispensing intervals to be calculated
• Check that the medicines are synchronized to a common dispensing date
Procedure
- Assessment of the prescription for validity, safety and clinical
appropriateness continued
• Check for ‘PRN’ items, these should be on a separate repeatable prescription form
• Check for any items which are not suitable for inclusion on a repeat prescription
i.e. antibiotics
• If a medicine is changed or a medicine is added during the lifetime of a repeatable
prescription, a new repeatable prescription and accompanying set of batch issues
must be issued by the GP for the new/amended item. This new repeatable
prescription should be valid for the same length of time as the original repeatable
prescription, so as the patient gets reviewed by the GP at the appropriate time.
Alternatively, the GP may prefer to issue a new repeatable prescription for all items
not just the amended item
• Check whether the patient has signed and completed the back of the batch issue
(NB: patients do not sign or complete the back of the repeatable prescription)
- Making interventions and problem solving
Follow normal procedure as per SOP (enter title and number) with the following
additions:
• Check that the patient’s condition remains stable and that the patient is; taking or
using the medicines, appliances, or reagents appropriately and safely, and requires
each item to be dispensed (may be the patient’s representative)
• Check whether with the patient is experiencing any side-effects (may be the
patient’s representative)
• Check that there have been no changes to the patient’s circumstances since the
last supply e.g. hospital outpatient clinic visit, any new symptoms etc.
• Check with the PMR and verbally with patient if there may be any other reasons
why any items should not be supplied
• Check if the patient is taking any OTC products which could cause any problems
• If an intervention has been made, code the batch issue with the intervention code
97001
• If an item has not been dispensed, code the item with the non dispensing
intervention code 97002
• Use the duplicate practice / pharmacy communication form to inform the GP about
any of the following:
• Errors • Adverse drug reactions
• Omissions • Medicines no longer required
• Unsuitable drugs • Medicines management issues
• Compliance problems • Patient no longer stable
• Early requests • Other (e.g. change pharmacy)
Repeat Dispensing Scheme
Standard Operating Procedure
Procedure
- Assembly and labelling of required medicine or product
Follow normal procedure as per SOP (enter title and number) with the following
additions:
• Before supplying subsequent batch issues check that the pharmacy holds the
repeatable prescription and that it has not expired
• Check that the pharmacy holds the repeatable prescription and batch issues if the
patient does not present one (NB There is no legal requirement to dispense in
numerical order, but it is good practice and should help avoid confusion)
• Check that any problems detected with the repeatable prescription are corrected
and reflected in batch issues
• Check that the medication is due and that the patient is concordant with the
medication regimen
• When dispensing PRN items check the time interval since the last supply, use
discretion as to whether supply is appropriate
• If the patient doesn’t want all of the items or full quantities, endorse the batch
issue with the quantity supplied or for medicines not dispensed use the non
dispensing intervention code 97002
- Checking procedure
Follow normal procedure as per SOP (enter title and number) with the following
additions:
• Check the batch issue against the original repeatable prescription, to ensure that
it is in date and that any problems with the repeatable prescription have been
corrected and amended in the batch issue accordingly
• Check the assembled medicines and batch issue against the PMR and ensure that
all appropriate changes have been made and there are no discrepancies
• If there are any concerns about safety or appropriateness contact the GP directly
or advise the patient to contact their GP
• Inform the GP if items are not supplied or if there are any problems using the
agreed communication process (give details of local procedure)
• If retaining batch issues on behalf of the patient, file the repeatable prescription
and batch issues in a safe and secure designated place within the pharmacy
(give details)
Procedure
- Transfer of the medicine or product to the patient
Follow normal procedure as per SOP (enter title and number) with the following
additions:
• Advise patient of the specified time interval before the next batch issue can be
dispensed
• When the last batch issue is dispensed advise the patient to return to the GP for
medication review and, if deemed appropriate, obtain a new repeatable
prescription
- Record keeping and completion of documentation
Follow normal procedure as per SOP (enter title and number) with the following
additions:
• Batch issues should be coded and submitted to the CSA with details entered on
the HS30 at the end of month in which they were supplied
• The repeatable prescription should only be submitted to the CSA only when; all the
batch issues have been supplied, the repeatable prescription has expired, or if the
prescribed medication is no longer required by the patient
• If a medicine is changed or a medicine is added during the lifetime of a repeatable
prescription, a new repeatable prescription and accompanying set of batch issues
must be issued by the GP for the new / amended item. This new repeatable
prescription should be valid for the same length of time as the original repeatable
prescription, so the patient gets reviewed by the GP at the appropriate time
• Alternatively, the GP may prefer to issue a new repeatable prescription for all items
not just the new / amended item. The old repeatable prescription should then be
endorsed no longer valid and forwarded to the CSA and any remaining batch issues
should be destroyed and a record kept of the destruction (give details)
• Any changes to the patient’s repeatable medicines must be recorded (in the
patient’s PMR) and reported to the patient’s GP where appropriate using the
agreed communication process