14-1_CDs_-_instalments_collection_PGD_BB_2022-23

Overview

  • Topic: Supply of Controlled Drugs and legal frameworks governing their dispensing.

  • Instructor: Professor Ellen Schafheutle, MPharm.

Intended Learning Outcomes

  • Ability to explain and apply legal requirements for controlled drugs:

    • Instalment directions

    • Collection of controlled drugs (CDs)

    • Patient Group Directions (PGDs)

    • Emergency supplies

Instalment Directions on Prescriptions for Schedule 2 & 3 CDs

  • General rule: Repeatable prescriptions are not allowed for Schedule 2 or 3 controlled drugs.

  • NHS Protocol: Use of FP10(MDA) for prescriptions.

  • Maximum prescription duration: 14 days for:

    • All Schedule 2 controlled drugs

    • Buprenorphine

    • Buprenorphine/naloxone

    • Diazepam on NHS instalment prescriptions in England.

Timeframe for Dispensing Instalment Prescriptions

  • Initial dispensing must occur within 28 days of the appropriate date.

  • Appropriate date: Defining date is:

    • Date of signing by prescriber

    • Date specified by the prescriber to not supply before.

  • Note: The start date can exceed 28 days from signing date.

Prescriptions for CD for Treatment of Addicts

  • Instalment prescription details must include:

    • Amount of medicine supplied per instalment

    • Interval of supply.

  • Prescription instructions must be followed strictly, including any specified starting dates.

Example Instalment Prescription

  • Patient: Mr Jamie Taylor-Wilson

  • Medication: Methadone oral solution (1mg/mL).

  • Dosage: 30ml per day, total 420ml, with supervision on collection days.

  • Collection dates are specified for each instalment.

Compliance Exceptions for Instalment Rx

  • Home Office approved wording: To be used when pharmacy is closed:

    • Dispense instalments on prior suitable days.

    • If a collection is missed, dispense remaining installments.

    • If 3+ days are missed, consult the prescriber.

    • Supervise collections and dispense weekly doses separately.

Handling Missed Doses

  • Recommendation: Do not supply if 3 days' supply has been missed (not a legal requirement).

  • Use the phrase: "Consult prescriber if 3 or more consecutive days of prescription have been missed."

Controlled Drug Prescriptions for Addiction Treatment

  • Specific drugs allowed for addiction treatment:

    • Cocaine

    • Diamorphine

    • Dipipanone

  • Prescribing restriction: Only doctors authorized by the Secretary of State may prescribe these medications.