Emergency Supply

 

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In an emergency, as a pharmacist working in a registered retail pharmacy, you can supply prescription only medicines (POMs) without a prescription at the request of a relevant prescriber or a patient.

Use this guide to find out about the requirements of an emergency supply and decide if an emergency supply is appropriate.

To supply or not to supply?

Consider:

  1. Each request on an individual basis.
  2. Taking a patient centred approach.
  3. What’s in the best interest of the patient.
  4. Using your professional judgement.

Take a look at our Mythbuster on emergency supply .This guide addresses and removes any myths/fears you may have about the General Pharmaceutical Council (GPhC) and your employer not approving your decision.

If you decide not to make an emergency supply:

Advise the patient how to obtain a prescription for the POM (if necessary).

Refer them appropriately to a prescriber, walk in centre, NHS 111, accident and emergency etc.

Make a record of your decision (e.g. in the POM register, PMR, etc).

Emergency supply checklist

Click on an option below (from the drop-down menu) to find out more about the requirements for an emergency supply from a prescriber or patient.

Emergency supply at the request of a Prescriber Emergency supply at the request of a Prescriber

 

Emergency supply at the request of a prescriber

Who can request an emergency supply

Conditions for supply

  • Request is from a relevant prescriber (check registration here).
  • It’s an emergency and the prescriber can’t give you a prescription immediately (e.g. patient can’t collect the prescription, the prescriber can’t drop off prescription to you or the patient urgently needs the POM(s), etc.
  • Prescriber agrees to provide you with a prescription within 72 hours.
  • POM(s) supplied as directed by the prescriber.
  • It’s NOT for a Schedule 1, 2 or 3 CD (except phenobarbital (phenobarbitone or phenobarbitone sodium) for the treatment of epilepsy.  NoteAn EEA or Swiss prescriber cannot request a Schedule 1, 2 and 3 CD including phenobarbital for any purpose or medicines that do not have a UK marketing authorisation. 

Maximum quantities

  • As directed by the prescriber.

Labelling

  • Usual labelling requirements apply — see MEP

Record keeping

Make an entry in the POM register on day of supply or next day with:

  • Date supplied
  • Name, strength, form and quantity of POM
  • Name and address of prescriber
  • Name and address of the patient
  • Date on the prescription
  • Date prescription received

 

Emergency supply at the request of a Patient Emergency supply at the request of a Patient

 

Emergency supply at the request of a patient

 

Who can request an emergency supply

Conditions for supply

  • Interview the patient. If this isn’t possible, e.g., if the patient is a child, or being cared for, etc. use your professional judgement and take a patient centred approach.
  • There’s an immediate need and the patient can’t get a prescription (e.g. they are out of town, etc).
  • POM(s) has been prescribed before by a relevant prescriber (check registration here). Consider time interval from when the POM was last prescribed to when it is requested. Use your professional judgement to decide if a supply or referral to a prescriber is more appropriate.
  • Dose is appropriate for the patient (e.g. refer to PMR, prescription repeat slip, labelled medicine box, electronic health records, etc).
  • It’s NOT for a Schedule 1, 2 or 3 CD (except phenobarbital for the treatment of epilepsy). Note: An EEA or Swiss prescriber cannot request a Schedule 1, 2 and 3 CD including phenobarbital for any purpose or medicines that do not have a UK marketing authorisation. 
  • It’s NOT for POM which contain the following substances:
    • Ammonium bromide, calcium bromide, calcium bromidolactobionate, embutramide, fencamfamin hydrochloride, fluanisone, hexobarbitone, hexobarbitone sodium, hydrobromic acid, meclofenoxate hydrochloride, methohexitone sodium, pemoline, piracetam, potassium bromide, prolintane hydrochloride, sodium bromide, strychnine hydrochloride, tacrine hydrochloride, thiopentone sodium.

Maximum quantities

  • Don’t supply more than five days treatment for phenobarbital, Schedule 4 and Schedule 5 CDs
  • Don’t supply more than 30 days treatment for other POMs, except:
    • Insulin, ointments, creams, or inhalers for asthma — supply the smallest pack available in the pharmacy
    • Oral contraceptives — supply a full treatment cycle
    • Oral liquid antibiotic — supply the smallest quantity that will provide a full course of treatment
  • You don’t have to supply the full 30 days. You can supply enough until the patient can get a prescription

Labelling

  • Usual labelling requirements apply — see MEP
  • The words "Emergency Supply" on the label

Record keeping

Make an entry in the POM register on day of supply or next day with:

  • Date supplied
  • Name, strength, form and quantity of POM
  • Name and address of patient
  • Nature of the emergency e.g. why the patient needs the POM, why a prescription can’t be obtained, etc

Remember

  • You can make an emergency supply even when the surgery is open and when out of hours services are available — trying to obtain a prescription first may delay treatment and potentially cause patient harm.
  • You can make an emergency supply to patients who are away from home — referring patients to the nearest surgery to register as a temporary patient may not always be appropriate.
  • Payment shouldn't be a barrier to you making an emergency supply — check your company SOP or policy, discuss it with your superintendent and see our Mythbuster on emergency supply.
  • Think about the risks associated with loaning POM(s) when legal mechanisms, e.g. emergency supply, exist to support patient care.
  • Think about potential abuse — e.g. PMR or pharmacy team indicate patient is regularly requesting an emergency supply.

 

Relevant prescribers

EEA or Swiss

  • Doctor
  • Dentist
  • Prescribing pharmacist
  • Prescribing nurse









UK

  • Doctor
  • Dentist
  • Supplementary prescriber
  • Community practitioner nurse prescriber
  • Nurse independent prescriber
  • Optometrist independent prescriber
  • Pharmacist independent prescriber
  • Physiotherapist independent prescriber
  • Podiatrist independent prescriber
  • Therapeutic radiographer independent prescriber


Other countries 

Healthcare professionals from countries outside of the EEA or Switzerland aren’t recognised as “relevant prescribers” in the UK.








How do I check registration?

Check registration of: 

  1. EEA or Swiss prescribers here
  2. Doctors here 
  3. Dentists here
  4. Nurses here 
  5. Optometrists here
  6. Pharmacist independent prescribers here
  7. Physiotherapist independent prescribers here
  8. Podiatrist independent prescribers here
  9. Therapeutic radiographer independent prescribers here


Any questions? 

Our dedicated Professional Support Service can help

0845 257 2570 / 0207 572 2737 (Monday - Friday, 9am - 5pm)

[email protected]