Dispensing Summary Sheets (final to print) PDF

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Summary

FP10 (green) Legal requirements: 1. Patient’s FULL name & address (need city not postal code) 2. If <12 years of age, then need age OR DOB (must say years/months/days) 3. Appropriate date (valid for 6 months unless, FP10CD in which is 28 days) 4. Written in ink 5. Can be written on carbon pap...

Description

FP10 (green) Legal requirements: 1. Patient’s FULL name & address (need city not postal code) 2. If 1), form, dose, and total quantity in words and figures 7. Prescriber’s signature 8. Prescriber’s full address, and type of prescriber (Dr., nurse and etc.) 9. Stamp- sign & date it Records: ● Sent to NHSBSA at end of month ● CD register keep for 2 years after last entry is made

Dentist (FP10D) (yellow) Legal requirements (same as FP10s); ● Valid only if in DPF ● DPF has generic names but may prescribe by brands ● A private Rx allows order of any GSL, POM or P medicine ● CD 2-3 MUST say “for dental treatment only” in middle section Records: ● Sent to NHSBSA at end of month ● CD register keep for 2 years after last entry is made

Always give PIL Remember it is good practice to not supply over 30 days CDs check with prescriber All CDs expiry is 28 days not 6 months (unless scd 5)

Private Rx (white) Legal requirements (same as FP10 green rx); ● Cannot give CD 2-3 (must be on pink FP10PCD), may give CD 4 ● Fill out POM register (refer to details below)

CD Schedules 2-5: Schedule 2 [CD POM] ○ (diamorphine, morphine, methadone, pethidine and oxycodone) ○ all except quinalbarbitone in the CD cupboard, incl. returns ○ Import & export licence ○ Identity of person collecting the CD, and ALL records in CD Schedule 3 [CD No Reg POM] ○ Only Temazepam, Buprenophine, Diethylpropion, Flunitrazpam are in the CD cupboard ○ same legal requirements as CD 2 but no CD register record Schedule 4 [CD Benz POM] and [CD Anab POM] ○ Part 1 [CD Benz POM]: benzodiazepines such as nitrazepam and diazepam (need licence) ○ Part 2 [CD Anab POM]: most steroids and growth hormones (no licence for import or export) ○ No CD register Schedule 5 [CD Inv POM/P]: ○ Dilute Schedule 2 drugs (invoice kept for 2 years) ○ No safe custody, No CD entry, No import/export restrictions

Records: ● Keep at pharmacy or give to patient ● Keep POM register for 2 years (do not send to NHSBSA) ○ Date of sale or supply ○ Name and quantity and, strength or form where not apparent ○ Date on the Rx ○ Name and address of practitioner ○ Name and address of patient ○ Reference#: on Rx, dispensing label and register ○ No record for health RX, OC, CD register or wholesale dealing

General.. ● ● ● ➔ ●

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NHS Repeat dispensing (FP10RD) ● Have RA (master prescription)- signed, and cannot be amended ● RD: the dispensing prescription (Upto 12 months of RDs) Legal requirements (same as FP10 green NHS Rx); ● First RD must be dIspensed within 6 months unless CD 4 then must be 28 days (CD 2-3 not allowed) ● Final RD must be supplied within 12 months ● Batches can only be dispensed at the pharmacy holding the RA Records: ● RA should be stored until the final RD is dispensed then sent to NHSBSA at end of the month ● Each RD is sent to the NHSBSA at the end of the month of dispensing

Private Repeat Rx Legal requirements (same as private rx): ● Cannot supply CD 2-3 ● Can supply CD 4, BUT within 28 days ● Must write number of dispensing ● Complete POM register ● After dispensing, Rx can be handed back to patient or can keep at pharmacy Records: ● If outstanding repeats, offer to give Rx to patient ● Keep in the Pharmacy for 2 years after final dispensing

Community Nurse (Liliac) Rx (FP10P) ● Note independent/supplementary nurse prescribers should use FP10 green (they are not restricted to NPF) Legal requirements (same as FP10s with 1 additional); ● Community nurse must prescribe within NPF (No CD 2-3 are in here, may see CD 4- but only valid for 28 days) Records: ● Sent to NHSBSA at end of the month

FP10MDA (blueish) Rx: to treat addiction; instalment prescribing Legal requirements: ● Must not exceed 14 day supply (CD 2,3,4) ● Doctors may prescribe cocaine, diamorphine or dipipanone withf licence ● Installment direction must contain: ○ the amount to dispense and when to dispense (date of each instalment) ● Same details as CD Rx, but also any supervision directions for pharmacists ● Check HOME OFFICE APPROVED WORDING on MEP PG 111 or 99 Records; ● Must fill out right hand side (date supplied, product supplied, quantity, and your signature) ● Keep at pharmacy until all have been dispensed then send NHSBSA at end of month ● Need letter of authority, or verbal confirmation from prescriber to allow this (annotate the PMR that unsupervised)

Emergency Supply at request of patient ● Patient must be interviewed, present immediate need, reason unable to obtain Rx, and previously prescribed ● To get information on patient’s past medication you can; contact GP surgery, contact usual pharmacy, access PMR, and SCR with consent ● Cannot supply CD 2-3 except phenobarbital (sodium) for epilepsy ● amount of CD 3,4,5 cannot exceed 5 days of treatment supply ● POM can be given but for a max of 30 days (except oral contraceptives, ointments/creams, insulin, inhaler for asthma, and antibiotic in liq. form for oral admin) ● For contraceptive or antibiotic supply full cycle worth of medicine or else try to give minimum amount needed ● The words “emergency supply” and “keep out of reach of children” must appear on the label Records: ● GOOD practice to complete POM register; should include: ● patients full name/address ● date of supply ● drug details-name, form, strength, total quantity supplied ● purpose of supply, Reason why rx can not be obtained, ref #, keep for 2 years

Private Control (pink) Rx (FP10PCD) ● Only contain CD 2-3 on FP10CD standardised form Legal requirements (same as FP10 (green) rx, CD with 1 additional) ● Must have prescribers ID # Records; ● Must make CD entry for CD 2, keep for 2 years and good practice to do POM register (since private) ● Must make POM register for CD 3 & keep for 2 years ● Sent original to NHSBSA ● Keep copy at pharmacy for 2 years

POM Requisition (signed order) No legal requirements however good to ensure; ● Person requesting is a recognized and qualified prescriber ● Good practice to supply whole packs of medicines & label stock ● Batch #, Ref # and expiry date ● NO LEGAL EXPIRY Records; ● Pom register is good practice, and kept for 2 years and should include: ○ name/address of person requesting ○ their profession ○ date of supply ○ drug details: name, form, strength, total quantity supplied ○ purpose of supply ○ ref # ● POM requisition should be kept at pharmacy for 2 years (becomes legally required if no signed order available) ● Sent to the NHSBSA at the end of the month

Emergency supply at request of prescriber Legal requirements; ● CD 2-3 cannot be supplied unless phenobarbital for epilepsy ● After supply, must get prescription within 72 hours (legal requirement) Records; ● LEGAL requirement to do POM register; ○ pts name/address ○ prescriber's name/address ○ drug details-name,dose,strength, and total quantity supplied ○ date of supply ○ date received & date on rx (left blank in exam) records kept for 2 years (3 dates in POM register)

➔ Patient group directives: ● All POMS, Ps, and GSLs; best for the treatment of acute conditions (ex. EHC, antimicrobials, analgesia, immunisation, and antiviral medicines) ● CDS: ○ Schedule 2: only diamorphine, morphine (only registered nurses and pharmacists for the immediate and necessary treatment of a sick or injured person) and ketamine ○ Schedule 3: only midazolam ○ Any schedule 4s (except anabolic steroids, and injectables used for treating addiction) and 5s ● May use unlicensed medication on rare occasions, if justified clinically and specified on the Rx

CD Requisition ● Receive requisition before supply of CD 2-3 (must use FP10CDF form) ● Reference #, batch #, expiry Legal requirements: ● Full name and address of recipient (profession or occupation) ● Signature of recipient ● Profession of recipient ● Total quantity of drug (does not need words and figures) ● Purpose of requisition ● Letter of authority if someone else collects Records: ● It is good practice to fill POM register: ○ name/address of person requesting, and their profession ○ date of supply ○ drug details such as name, form, strength, total quantity supplied,and purpose of supply ● CD register for Schedule 2 as normal ● Original sent to the NHSBSA at the end of the month ● Copy of the requisition kept in the pharmacy for 2 years (good practice) ➔ Non-medical Prescribing ● Prescribing by non-healthcare professionals ○ Supplementary Prescribing (SP): take responsibility for the management of a patient who has been assessed and diagnosed by an IP ■ No restrictions: CDs, black triangle meds, off-label meds, and unlicensed as long as on the CMP ○ Independent Prescriber (IP): responsible for the initial clinical assessment, diagnosis, prescribing and follow-up ● Clinical Management Plan (CMP): specific to the patient, and sets out what responsibility is delegated, agreed and signed by both the SP and IP; must include ○ Date of commencement and review ○ Specify the range of medicines that may be in the Rx

➔ Standard Labelling Requirements (POM and P in rectangle boxes) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. ➔ ● ● ● ● ●

Name of the product (trade name) Recommended International Proprietary name (rINN) Statement of active ingredients and strength Pharmaceutical form AND Route of Administration statement List of excipients (with known actions/effects) BUT if eye prep, injection, or topical PREP, must list all excipients Special warning: Keep out of reach & sight of children Any warnings particular to the product Expiry date in clear terms (if any) Special storage conditions, precautions for disposal, if any MA holder’s name, address, PL number Batch reference (or LOT #) If product is for self administration, then instructions for use GOOD PRACTICE: BNF cautionary labels in patient friendly terms

Paracetamol If symptoms persist contact your GP Contains paracetamol Do not exceed the stated dose Do not take with any other paracetamol-containing products Immediate medical advice should be sought in the event of an overdose even if you feel well (if PIL included) ○ Immediate medical advice should be sought in the event of an overdose, even if you feel well, because of the risk of delayed, serious liver damage (if no PIL) ➔ Dihydrocodeine and Codeine ● Can cause addiction. For three days use only. ➔ Child Safety Regulations ● All products with aspirin, paracetamol, and elemental iron > 24 mg in tablet, capsule, lozenge, pastille, suppositories, or oral liquid form sold or supplied must LEGALLY be in the CRC ● All cough and cold oral liquid products for children with antihistamines, antitussives, expectorants, and decongestants must LEGALLY be in the CRC

➔ Veterinary Prescriptions

1. AVM-GSL: authorized VMP that is available on general sale 2. NFA-VPS: for a non-food producing animal. Vet, pharmacist and a suitably qualified person can supply without a prescription 3. POM-VPS: VMP that a vet, pharmacist and suitably qualified person can prescribe, and supply on ORAL or WRITTEN prescription. Written prescription needed if the supplier is not the prescriber. 4. POM-V: VMP that ONLY a vet can prescribe on a written prescription. Vet and pharmacist can supply. ● The Rx is only valid for 6 months ● Needs to say “prescribed under the cascade” and “for animal treatment only (on the label)” ● Name, address, and telephone number of the prescriber ● Professional qualification of the prescriber ● Name/address of owner ● Type of species ● Animal’s address if different from the owner/keeper ● Signature of prescriber ● Date of prescription ● Name/quantity of product ● Dosage and administration instructions (‘as directed’ is not ok) ● Any necessary warning and/or withdrawal effects if necessary ➔ Scds ⅔ legals: ● The prescriber’s address must be in UK ● RCVS Registration # of prescriber ● Dosage form of the medicine ● Strength when appropriate ● Total quantity in (words & figures) ● Statement confirming ‘item has been prescribed for animal/herd under care of the veterinarian’ ● Name/address of recipienT ● NO REPEATS for CD 2-3 ○ Valid for 28 days (CD 2-4), not sent to the NHSBSA, and specials forms N/A ➔ Records: ● POM register kept for 5 years; ○ Date of supply, Name of medicine, Batch number, Quantity ○ name/address of recipient and prescriber, Reference #...