Pharmacy leaders warn patients put at risk by medicine supply shortages after Lancashire toddler's death

The National Pharmacy Association (NPA), which represents 6,000 independent community pharmacies, said the Government must urgently grant much greater flexibility for pharmacists to substitute medication when it is safe to do so.

At the moment, patients must go back to their GP for a new prescription if the item or dose they have been prescribed is out of stock.

The only exception to this rule is in very limited circumstances when a Serious Shortage Protocol has been issued by the NHS.

In January, Lancashire coroner Christopher Long wrote to Health Secretary Wes Streeting on this issue following the death of two-year-old Ava Hodgkinson.

He told how she died of overwhelming sepsis from a strep A infection after delays in receiving antibiotics due to restrictions preventing a pharmacist from amending an out-of-stock prescription.

Join our new WhatsApp Community to get the latest news and top stories from across Lancashire directly to your phone

Mr Long wrote: “Ava had seen her GP who had prescribed amoxicillin with a dose of 250mg/5ml.

“The pharmacy did not have this strength in stock but did have amoxicillin 125mg/5ml in stock.

“(They) could not issue this as restrictions currently in place prevent a pharmacist issuing any different strength of medication without an amended prescription, even where the medication can be provided to enable the same dose to be administered (here Ava’s parents could have been instructed to provide 10ml enabling the same dose of antibiotics to be provided).

“This led to a delay in Ava receiving antibiotics.”

Get the latest headlines, straight to your inbox, with The LEP’s free emails

The NPA said the rules must change, and quickly, adding it believes any changes being currently considered by the Government are too limited in scope.

It said its survey of 500 pharmacies found all were unable to dispense a prescription at least once a day due to supply problems.

Most (95%) also reported patients coming to their pharmacy at least once a day to get medicines they had failed to obtain elsewhere due to supply problems.

Furthermore, 96% of pharmacies told how they were unable to dispense a prescription at least once a day, despite having a safe alternative formulation in stock.

Nick Kaye, chairman of the NPA, said: “These are deeply concerning statistics which show that patients are potentially having to forgo vital medication due to shortages.

Get the latest headlines, straight to your inbox, with The Gazette’s free emails

“Pharmacies are at the sharp end of medicines shortages and frequently have to turn away distressed, frustrated and sometimes angry patients.

“It is particularly frustrating for pharmacists to be unable to meet a clear need when they have a perfectly safe and effective solution in their pharmacy already.

“It is madness to send someone back to their GP and it risks a patient either delaying taking vital medication or forgoing it altogether, which poses a clear risk to patient safety.

“We’re pleased the Government are taking steps to bring together manufacturers, wholesalers and pharmacies to try and tackle this issue.

“However, the Government must look again at allowing pharmacists – who are highly trained healthcare practitioners – to use their professional judgment to supply an appropriate alternative when the prescribed version is unavailable.”

A Department of Health and Social Care spokesman said: “Community pharmacies have a vital role to play as we shift focus of healthcare out of hospitals and into the community as part of our Plan for Change.

“We will work with the sector, making better use of the skills of pharmacists and pharmacy technicians, to build a service fit for the future.

“The Government is currently considering enabling pharmacists to substitute to a different dose or formulation, under specified circumstances, where such a substitution might be both urgent and safe.”