GPs in Wales will vote on whether to ask NHS Wales to allow pharmacies to substitute medication that is in short supply.

The motion, submitted to the annual Welsh Local Medical Committees (LMCs) conference, notes that currently, pharmacist dispensers are 'constantly referring back to the prescriber' when an amended prescription is needed because the prescribed medication is out of stock.

At the meeting next month, Welsh GPs will be asked to vote on 'requesting NHS Wales to allow flexibility to pharmacies to substitute medication that is in short supply'.

In January, the Department of Health and Social Care (DHSC) said it was considering enabling pharmacists to substitute to a different dose or formulation, under specified circumstances, where such a substitution might be both urgent and safe, and that further details would be set out in due course.

And earlier in the year, the government 'partially accepted' a parliamentary recommendation that regulations be updated promptly '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'.

In response to that recommendation, the government said that requiring pharmacists to supply exactly what was written on the prescription 'works well as prescribers have certainty of what their patient is receiving; the clear separation of roles, prescribing and dispensing, supports patient safety, with a double clinical check on dose and interactions; and patients have consistency as to their dosing regimen'.

And it warned that 'allowing pharmacists to take local action to alter prescriptions and supply an alternative without an SSP in place and without the full oversight of supply issues that the DHSC Medicines Supply Team has, could have the effect of creating a "knock-on" shortage of the alternative and could thereby have the potential to exacerbate rather than mitigate a supply problem'.

But it said that it did recognise 'there may be occasions where it is appropriate to enable further flexibility to supply an alternative dose or formulation to what was prescribed without going back to the prescriber'.

GPs to call for NI and estates funding and note weight-loss jab workload

At the conference on 8 March, LMC leaders in Wales will also discuss recent budget changes, including the rise in National Insurance contribution, and the impact these will have on practices, and call on the government to ‘find a solution’ to ‘fully’ mitigate this.

The conference agenda also includes a motion noting the ‘unprecedented’ pressure on primary care due to unresourced work fuelled by the ‘significant’ rise in demand for weight loss medications, and calling for a ‘properly funded’ national obesity service.

Welsh cabinet secretary for health and social care Jeremy Miles will also deliver a speech at the conference.

Other motions which will be discussed are:

  • Demanding a commitment to ‘substantial’ allocations of ring-fenced new monies to improve GP estates
  • Asking that GPC Wales negotiates a new dispensing contract for GPs that ‘properly supports’ dispensing practices
  • Calling for ‘appropriate’ investment in digital infrastructure to address inefficiencies, reduce administrative burden, and improve patient care
  • Calling for all GP partners to undertake a ‘minimum’ number of clinical sessions in their practice annually, including face-to-face appointments
  • Calling for the implementation of a single electronic pathology and radiology requesting service accessible to both primary and secondary care clinicians

A version of this article first appeared on our sister publication Pulse.