Patients who contact NHS111 needing an emergency supply of prescription only medication will be referred to a community pharmacy. The pharmacy can then provide an emergency supply if the request meets the requirements of the Human Medicines Regulations.

The process

• Step 1

  Patients will be referred to the pharmacy by NHS111. A message will be sent electronically via PharmOutcomes with a back-up referral sent by NHSmail.

• Step 2

  The patient phones the pharmacy. If the patient does not make contact within 30 minutes of receiving the referral the pharmacy should make at least one attempt to contact the patient.

• Step 3

  The pharmacist assesses the need and legality of providing an emergency supply. The pharmacist should consult the Summary Care Record as part of this assessment.

• Step 4

  The pharmacist decides to supply the medicine as an emergency supply, OR

• Step 5

  The pharmacist decides not to supply the medicine. This may be because an EPS prescription is available, the patient buys the item, or it is not necessary or appropriate. Alternatively, the patient may need to be referred to their own GP or an out of hours GP if, for example, the request is for a controlled drug.

• Step 6

  Complete the consultation on PharmOutcomes.

Call handlers at NHS111 are not clinical staff; they will not know whether a product is a controlled drug or assess the appropriateness of an emergency supply. The pharmacist will normally be the first clinician to speak with the patient. You may also get patients referred to the pharmacy for items that you do not have in stock. In both these cases the pharmacist is expected to resolve the patient's need by either contacting the patient's GP or out of hours GP service, or by making attempts to locate the item at another pharmacy. By doing this the consultation will have been completed and the pharmacy will be paid for the service.

Pharmacists must never tell the patient to ring NHS111 again. Pharmacies are provided with local “back door” numbers for NHS111 providers and out of hours GP services to hand over the patient to alternative services to meet their need.

Records

Records need to be made to meet requirements of the Human Medicines Regulations as well as the CPCS:

• PMR – records need to be kept in the PMR to create a label for the medicine(s) and to enable the supply to be remunerated and reimbursed. It may also be good practice to record the request even if no supply is made
• PharmOutcomes – the consultation must be completed to ensure payment. If a supply is made a record will be sent to the patient’s GP. If no supply is made the reason for not supplying should be recorded
• The POM register – this is the legal record required for an emergency supply.