Pharmacists throughout the whole of the supply chain have a responsibility for procuring and supplying specials in a professional manner. We are aware that the supply chain encompasses manufacturing, prescribing, procuring and dispensing of specials. This guidance only addresses part of that whole process. Other parts need to be considered by other organisations. Over the last few years pharmacists have increasingly bought in specials rather than prepare products extemporaneously within the pharmacy setting. This practice has arisen from a need to ensure quality in the manufacturing process and to enhance patient safety. This guidance provides good practice advice on the key professional responsibilities for pharmacists when providing advice about or supplying specials, and support in making appropriate choices for their patients. There are patients who do benefit from receiving a special and this guidance will help pharmacists in providing the appropriate product and advice for their patients.

n.b: this guidance is specific to the use of specials. It does NOT apply to licensed products used outside the clinical indications of their licence i.e. “off-label” use.

Community, hospital, primary care and industrial pharmacists are encouraged to engage with one another and with prescribers to discuss the issue of specials. This can lead to a more efficient procurement of specials within the locality Pharmacists also need to raise awareness of prescribers to the issue of specials as they themselves are not always aware they are prescribing a special and therefore will not be aware that as a bespoke special it is likely to be more expensive to procure than a licensed product. The Society would like to thank the contributors from Hospital, Primary Care and Community practice, specials Manufacturers, NHS Quality Assurance and PSNC for their help in developing this guidance.

Content
The document is divided into 8 sections:

1. Purpose of this document
2. General Information about specials
3. Key Professional Responsibilities
4. Assessing Clinical Need
5. Choosing a Suitable Product
6. Choosing a Suitable Supplier and Placing an Order
7. Good Record Keeping
8. Useful Resources
9. Glossary of terms and abbreviations
10. Annex A – Hierarchy of risk
11. Annex B – Decision aid flowchart

If you have any enquiries about this guidance, please contact the Support Team on 0207 572 2302.

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