The Equality Act 2010 and 28 day prescribing
The Equality Act 2010 and 28 day prescribing
Many of the queries that PSNC receives about support for patients who have a disability concern requests from prescribers carers and relatives to dispense weekly into compliance aids. The NHS Terms of Service do not impose a requirement to dispense into compliance aids or to dispense in instalments (other than instalment prescriptions for the treatment of substance misusers). Therefore a prescription ordering treatment for 28 days should be dispensed on one occasion. It is for the pharmacy contractor to decide whether it is appropriate to dispense into a compliance aid.
If a prescription for 28 days’ treatment is issued for a patient who satisfies the Equality Act 2010 criteria, and the pharmacy contractor decides that the adjustment required is a compliance aid, then 4 x 7 day compliance aids or 1 x 28 day compliance aid should be prepared on one occasion.
There is no obligation under the Terms of Service or within the Equality Act 2010 for the pharmacy to amend what has already been dispensed, mid-way through a course of treatment. Therefore, alterations to treatment should be authorised by the production and dispensing of another prescription, with the previously dispensed items discarded.
If a patient’s medicines are dispensed in compliance aids because of an established need under the Equality Act 2010, and an additional medicine is prescribed during the time that the compliance aid is in use, this should result in a completely new compliance aid being prepared. Dispensing a separate container of the ‘new’ medicine to be used in conjunction with the previously supplied compliance aid would cause confusion and could result in the medicines not being taken appropriately.
As stated above, there is no obligation on pharmacy contractors to amend what has already been dispensed, so the prescriber would be obliged to make an Equality Act 2010 adjustment, by issuing a prescription for all the current medicines, so that they can all be dispensed into a new compliance aid. For this reason, prescribers could be advised to issue 7 day prescriptions, if the patient frequently has changes made to prescribed medicines.
Where prescribers order in 28 day (or longer) periods, but recommend that the medicines are dispensed weekly, or in compliance aids (for patients not entitled to this support under the Equality Act), this should be facilitated by a locally commissioned service.
Related resources
PSNC Briefing 054/16: Medicines Wastage and Prescription Duration (October 2016)
This PSNC Briefing updates PSNC Briefing 086/13: Medicines Wastage and Prescription Duration, which summarises information on prescription duration and medicines wastage. This Briefing also highlights literature on the environmental impacts of waste medicines which are not disposed of correctly.
