Pharmacies across the UK could potentially dispense up to 10% more or less medication than the prescribed quantity, under proposals that would ensure original pack dispensing (OPD) as standard.

Pharmacy staff are currently required to supply the exact quantity of medication prescribed, meaning staff may have to split medicine packs when a prescription is not equal to the pack size.

But a spokesperson from the Association of Independent Multiple Pharmacies (AIMp) said they do not believe that the proposals go far enough to achieve its goal.

AIMp said: ‘Given that the main point of the consultation is to ‘explore and implement greater use of original pack dispensing to support efficient automation’, we do not feel the proposals go far enough.

‘Only allowing a 10% increase in prescribing would not necessarily allow the quantity to be made up to a full pack, resulting in the continued generation of split packs and items not being dispensed in original packs,’ they explained.

The Government consultation, launched by the Department of Health and Social Care (DHSC) this week (1 November), also proposes that sodium valproate to always be supplied in its original packaging.

Benefits of original pack dispensing

The current system not only leaves room for medication dispensing errors, but takes up dispensing time, and also reduces the cost-effectiveness of automated dispensing, the document suggested.

If the proposals for OPD are accepted pharmacists would have ‘flexibility to dispense [up to 10%] more or less than the prescribed quantity if that means they can dispense in the manufacturer’s original packs’.

This would give pharmacy staff ‘more time for other tasks such as providing clinical services to patients,’ the consultation document suggested.

‘OPD will mean more prescriptions can be assembled using an automated process and so there will be synergistic efficiencies gained by use of hub and spoke dispensing and automation,’ it added.

The Government’s consultation document also noted: ‘By dispensing medicines in their original packs, it will be easier for pharmacies to ensure that patients will receive the patient information leaflet (PIL), which provides detailed information on the safe and effective use of the product.

‘It would also mean patients will get complete packs where the days of the week are marked.’

This would potentially make it ‘easier for patients to see whether they have taken their medicine that day and how many they have left’.

Authors of the consultation considered the risk of giving patients too much or too little medication as a result of the OPD proposal.

However, the document said that given that 77% of all prescription items are repeat prescriptions ‘an increase or decrease would most likely mean that the patient would access their next repeat prescription either a few days earlier or later than they would have done’.

It added: ‘Judgement by the responsible pharmacist will remain an important part of the dispensing process; for instance, there are some prescriptions such as a course of steroids or antibiotics where a decision may need to be made not to give people less, so they have enough to finish their treatment’.

Each of the devolved UK nations will be able ‘to consider how they want to implement this enabling flexibility within their respective NHS services’.

The consultation also proposes only supplying sodium valproate in its original packaging to ensure patients receive product information and labelling as part of the Pregnancy Prevention Programme.

Sector to respond to the proposals

Gareth Jones, head of corporate affairs at the National Pharmacy Association (NPA), said: ‘[The NPA] have long supported a move to dispensing in original packs wherever possible, to improve both efficiency and patient safety. The UK is out of step with many other countries in terms of how dispensing is currently handled.

‘As the Medicines Safety Officer for the independent sector, we also support measures to enhance the safety of the supply of sodium valproate specifically.

‘We will need to study the consultation in detail before finalising our position on these proposals.’

The Royal Pharmaceutical Society (RPS) said it would not be commenting on the consultation until the organisation had engaged with stakeholders and board members.

The consultation closes on 13 December 2021.