Legislation should be changed within three months to allow community pharmacists to amend prescriptions in the case of shortages, a parliamentary committee has recommended.

‘Medicine shortages cannot be ignored and left to become the norm,’ a Health and Social Care Committee (HSCC) report, published today, stated.

And it warned of a ‘serious risk that any capacity that general practice gains, through services like Pharmacy First, will be negated by the time spent re-issuing prescriptions as a result of shortages, thus undermining this initiative’.

‘Public concerns about being referred back to the GP if they use community pharmacy to access healthcare should ring alarm bells for the government,’ the report said.

Further recommendations to combat medicines shortages included:

  • An independent review of the medicines supply chain, commissioned by the government ‘as soon as possible’ and completed within six months of starting. ‘The review should assess, and suggest ways of improving, the resilience of the supply chain, the performance and role of the MHRA and the impact of prices paid for medicines and community pharmacy reimbursement mechanisms,’ the HSCC said.
  • Reviewing the effectiveness of Serious Shortage Protocols (SSPs), ‘with a focus on their timing and their administrative burden’;
  • The introduction of generic substitution, following a government consultation;
  • The government to ‘set out what impact it believes National Patient Safety Alerts have on private prescribing’, and ‘what scrutiny and enforcement measures are in place to ensure private prescribers adhere to these alerts’. This followed concerns raised within the committee’s parliamentary inquiry about off-label prescribing of glucagon-like peptide-1 receptor agonists (GLP-1s) impacting supply for NHS diabetes patients.

These came in addition to the recommendation that 'regulations are updated within three months to allow pharmacists in community settings to make dose and formulation substitutions for out-of-stock items, subject to the safeguards set out in the Royal Pharmaceutical Society’s Medicines Shortage Policy'.

Earlier this year, pharmacy minister Dame Andrea Leadsom said the government had ‘no plans’ to allow community pharmacists to amend prescriptions.

But health secretary Victoria Atkins later told the HSCC pharmacy inquiry that the Department of Health and Social Care (DHSC) had ‘not made a decision’ on the issue, and The Pharmacist understands that the chief executive of the General Pharmaceutical Council (GPhC) has met with the government to discuss it.

The HSCC also found that the Community Pharmacy Contractual Framework (CPCF) is ‘not fit for purpose’ and should be ‘completely overhauled’, with ‘urgent’ reform of the way pharmacies are funded.

Commenting on the report, Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), highlighted that on top of funding pressures, 'due to medicines shortages' community pharmacies were 'spending hours and hours every day trying to source medicines for patients'.

'This has all led to many pharmacies sadly closing their doors for good and patients having to travel further to get care,' she added.

'We are overjoyed to finally hear some clear thinking from an independent review body as we have been shouting loud and clear for years now that the community pharmacy contract is broken, and that our medicines supply system needs urgent review,' Dr Hannbeck said.

And Paul Rees, chief executive of the National Pharmacy Association, commented: 'There are many sensible detailed recommendations about chronic problems with medicine supply and other issues facing pharmacies and their patients every day. The next government needs to read this report, act on it and help save our pharmacies, otherwise millions of voters will be the poorer.'

Meanwhile, Janet Morrison, chief executive of Community Pharmacy England, said that ahead of the general election, the negotiator was 'urging all political parties to commit to supporting community pharmacies and their patients by introducing a long-term sustainable funding model, reviewing the medicines supply chain and investing in the clinical future of community pharmacies including through workforce planning and support'.