OSPAP MPHM15: Prescription Only Medicines

OSPAP Programme: Sale and Supply of Medicines - Part 3: Prescription Only Medicines (POMs)

• The presentation is about Prescription Only Medicines (POMs)
• The date of the presentation is October 2/9th, 2024.
• The presenter is John Sherwood MRPharmS.
• The presentation is part of the OSPAP MPHM15 course.
• Learning outcomes include defining POMs, identifying where legal classifications are found, describing lawful administration, listing legal prescription requirements, detailing POM register entries, and describing dispensing circumstances.

Learning Outcomes

• Provide a definition for a POM and list three places where the legal classification may be found.
• Describe how POMs can be lawfully administered and by whom.
• List the legal requirements for a POM prescription.
• List the details required for recording in the POM register and describe when a record is necessary.
• Describe limitations regarding dentists, community nurses, and prescription types (NHS/private).
• Explain issues surrounding faxed/forged prescriptions.
• Describe issues related to dispensing different quantities than prescribed and conditions in which this isn't permissible.
• Explain the concept of 'hub and spoke' dispensing and how the law applies to this.
• Describe the legal defence for dispensing errors.
• Explain serious shortage protocols and when they are used.
• Outline concerns regarding online pharmacies.
• Describe the use of PCUs and their suitability for specific medications.

Definition of a POM

• A medicine with a POM classification in the marketing authorization or POM Order.
• Includes medications for which a practitioner prescription is required.
• Patient specific directions (PSD) are written instructions for medication administration.
• A person may not sell or supply a POM except in accordance with a prescription given by an appropriate practitioner. Exceptions include emergency supplies, Patient Group Directions (PGDs), or patient-specific directions in hospitals.

Products Always Classified as POMs

• Parenteral products.
• Controlled Drugs (CDs), unless the product monograph lists it as a Pharmacy or General Sale List (GSL)
• Cyanogenic substances (unless for external use).
• Medicinal substances that emit radiation on administration.
• New chemical entities.

Dispensing Prescriptions for POMs

• Legal requirements for POMs include issue by an appropriate practitioner, ink signature, and written in an indelible format.
• Required components: the appropriate practitioner's address, the date of prescription, type of practitioner, patient's name and address, and age if under 12.
• The prescription is valid for six months from the appropriate date.
• Requirements for repeatable prescriptions.
• Additional considerations for controlled drugs and repeats.

Definition of "Appropriate Practitioner"

• Includes a wide variety of healthcare roles including doctors, dentists, community nurse prescribers, supplementary prescribers, and various independent prescribers (e.g. pharmacist, optometrist, physiotherapist, podiatrist, etc.).

Important Points about Prescriptions

• "An indication of the kind of practitioner" explained.
• Information and clarity on dates.
• Importance of verifying the prescription's authenticity.
• The use of prescription details - example prescription shown.

Private Prescriptions

• Follow legal requirements outlined for POM prescriptions
• Can be written on any form and by any appropriate practitioner.
• The date on private prescriptions is the date when the prescription was signed
• No restrictions regarding which medications can be prescribed.
• Should be verified as genuine.

Repeatable Prescriptions

• Definition a repeatable prescription
• No repeat dispensing scheme for FP10
• No legal repeat limits (unless it is for oral contraceptive, see further notes)
• Prescribing should follow clinical judgement.
• Correct marking for repeat prescriptions.

Dispensing Valproate-Containing Medicines

• Information about safety for unborn babies.
• Current laws require use of complete packs - not repackaging.
• Only the nearest quantity may be dispensed.

Non-UK Prescriptions

• Prescriptions from other countries are recognized if from an approved professional in an approved country.
• Legal requirements: Patient details, prescriber details, full name of medical product, dosage or route, quantity, prescriber signature, date of issue.
• Important to verify prescriber information and registration status
• Note that for these prescriptions you need to assess risk to the patient and whether to dispense.

Prescription Records (1 & 2)

• Record keeping requirements for all supplies of POMs.
• Records for wholesale dealing.
• Records must be retained for two years.
• Details to be recorded (date, name, quantity, form, strength, practitioner details, patient details).

Fate of Dispensed Prescriptions

• NHS prescriptions sent to the NHS Business Services Authority.
• Non-repeatable private prescriptions are kept in the pharmacy for two years.
• Repeatable private prescriptions kept for two years from the final repeat.
• Handing prescriptions for repeats to patients for outstanding repeats or keeping at the pharmacy.

Hub and Spoke Dispensing

• Explanation of the process.
• Advantages/disadvantages.
• Current considerations - new law and changes.

Dispensing Errors

• Definition of errors.
• Criminal offence if certain errors or types occur.
• Legal defence if due diligence occurs.

Internet/Online Pharmacies

• Detailed explanation of the current situation and risks.
• Key guidance from GPhC.

Prescription Collection Units (PCUs)

• Description and operation.
• Suitable/unsuitable medicines.
• Additional info or guidance from the GPhC about use.

Forged Prescriptions

• Importance of checking for forgeries.
• Due diligence procedures regarding forgeries.

Prescribing POMs in Hospitals (for inpatients)

• Information regarding patient specific directions in hospital settings.
• Clarity on requirements for dispensing.

Administration of a POM

• Guidance on administering POMs.
• Notes on exemptions.

Self-Checking Prescriptions

• Explanation of the procedure for self-checking prescriptions.
• The importance of two people involved to avoid dispensing errors.

This quiz focuses on the Sale and Supply of Prescription Only Medicines (POMs) as part of the OSPAP programme. Learn to define POMs, identify legal classifications, and understand prescription requirements and dispensing circumstances. Prepare to enhance your knowledge and compliance in this crucial area of pharmaceutical practice.