Pharmacy First - Urgent Medicine Supply - Controlled Drugs

The LPC would like to remind pharmacies about controlled drugs within the Pharmacy First Service.

​The urgent medicines supply strand of the Pharmacy First service follows the same rules and legislation as any other emergency supply.

A referral from NHS 111 does not automatically indicate that an emergency supply is appropriate; that is for the pharmacist to determine. Pharmacists who receive referrals for urgent supplies should use their professional judgement to determine whether an emergency supply is appropriate and legal to make. If it is not, the patient may need to be escalated to the GP OOH service or signposted to their own GP practice. Particular care should be taken when deciding to supply any medicine that has a potential for misuse.

The Human Medicines Regulations 2012 (HMR) set out the maximum quantity of a POM that can be supplied as an emergency supply. Professional judgement should be used to supply a reasonable quantity that is clinically appropriate, particularly where the requested medicine is liable to misuse.

To make sure urgent medicines supplies for Controlled Drugs are provided appropriately, please remember that:

• Emergency supplies of Schedule 2 and Schedule 3 Controlled Drugs are not permitted by the HMR, with the exception of phenobarbitone or phenobarbital sodium for the treatment of epilepsy;
  
  
• Temazepam, gabapentin, pregabalin and tramadol are all Schedule 3 Controlled Drugs. Emergency supplies of these medicines are not allowed and so they cannot be supplied via the service;
  
  
• Medicines such as benzodiazepines, zopiclone, and zolpidem are Schedule 4 Controlled Drugs. Up to five days’ treatment may be supplied, if it is clinically appropriate and after an assessment has been made of the risk that the patient is using the service to inappropriately gain additional supplies;
  
  
• Medicines such as dihydrocodeine and codeine containing products (including co-codamol 30mg/500mg) are Schedule 5 Controlled Drugs. Up to five days’ treatment may be supplied if it is clinically appropriate and after an assessment has been made of the risk that the patient is using the service to inappropriately gain additional supplies.
  
  
• Where the legislation does permit an emergency supply, it limits the supply to a maximum of 5 days for Controlled Drugs;

 Further Information can be found on the CPE Webiste
 
https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first- service/pharmacy-first-service-faqs/