Medicines Shortage Guidance

Out of Stocks Medicines – October 2022

During a recent Devon LMC & Devon LPC meeting, the issue of out-of-stock notifications was brought up. As out of stocks are becoming more frequent, rather than just sending the patient back to the GP for an alternative, the LPC was asked to update the notification routes and we have agreed to work with them on this.

Many PCN’s use WhatsApp to communicate with each other but we know of some that don’t. There was a CCG (now ICB) form produced a while ago that has recently been updated and amended by the LPC and reviewed by the LMC. This form would be filled in by the pharmacist and sent to the practice (with the patient or via email). It has been made clear that this is not prescribing advice but a stock availability notice, with alternatives that are available rather than a ‘recommendation’. The aim of this is to help improve communications with the practices to build relationships and trust, and to make it easier for patients to access available suitable medicines in a timely manner. The form has been uploaded here for you to download and use as needed.

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Colleagues will be aware that there is a contractual requirement for medicines and appliances ordered on NHS prescriptions to be dispensed with reasonable promptness by community pharmacies and other dispensing contractors. Currently there are  an unprecedented number of medicines in short supply however.

Staff working in primary care (both in general practice and community pharmacy) are often working under considerable pressure and we are aware that liaison between the two teams in relation to out of stock medicines has caused frequent operational difficulties with patient care, and frustration for all parties

If dispensing contractors are struggling to obtain products for less than the Drug Tariff price, they should notify the Pharmaceutical Services Negotiating Committee so that they can advocate on their behalf to get a price concession from the Department of Health & Social Care to ensure that pharmacies are not dispensing at a loss. http://psnc.org.uk/dispensing-supply/supply-chain/supply-issues-feedback/

If a prescribed medicine is out of stock, ensure all options to help the patient get their treatment have been considered before contacting the prescriber. If the prescribing practice is contacted to discuss an alternative, let practice staff know when the item prescribed will be back in stock (see overleaf) and which potential alternatives are in stock to avoid having to go the process twice.

NHS England SW have issued guidance (June 2018)