Board accepts recommendation to limit dispensing
NHS Grampian has accepted the recommendations of a review group, set up to decide the fate of the dispensing Haddo Medical Group.
The accepted recommendations are that
- NHS Grampian should conduct a review of GP practice prescribing across the region to formulate clear objective criteria around interpretation of the GMS regulations to ensure patients have access to the most appropriate services to meet their clinical needs.
- the Haddo Medical Group should be allowed to continue dispensing to patients who have a serious difficulty in obtaining their medication, but that this authority should be limited to dispensing to patients who have serious difficulty by virtue of both the need to obtain medication following the issuing of an acute prescription and that on that day they do not have access to a car to travel to a pharmacy.
The review group meeting held in mid-January represents an emergency measure taken by NHS Grampian following a pharmacist-led judicial review. This review decided that NHS Grampian had acted unlawfully by allowing the Haddo Medical Group to continue dispensing for all patients except those living in Tarves.
In the review meeting, the panel of NHS Board executive and non-executive members highlight that there are no Scottish or NHSG guidelines to offer a method of deciding on access (serious difficulty) to medicines under the Scottish pharmacy regulations. In making their recommendation, the review group looked at the specific difficulties faced by the local population, and concluded that there was “little to suggest that chronic or repeat prescriptions should present a serious difficulty for patients as the supply of the medication could be carried out in a planned manner or delivered directly to home.”
However, they accepted that acute prescriptions offer more challenges “as planning is more difficult, the individual may be incapacitated by illness and the medication is more likely to be required urgently. Individuals without access to a car for whatever reason on the day they receive their acute prescription might therefore have considerable difficulty and delay in obtaining their medication”.
They add that home delivery seems an unlikely universal solution for these patients, as same day supply would be problematic particularly in afternoon or late clinics. Of course there may be rare exception circumstances where other patients are unable to access the pharmacy e.g. road closure etc.
Further information and comments from interested parties relating to the Haddo dispensing review can be found here. Commenting on its acceptance of the decisions, NHS Grampian said: “This… was a difficult decision to make. The board is very aware of the strength of feeling around this issue. We now have to consider the implementation of this decision. We want to work with all local stakeholders to ensure sustainable medical services for the entire practice population.”
A further update will follow the NHS Grampian board meeting in March.