GPs back pharmacist medication substitution to counter 'disastrous' shortages

By Chloe Harman on the 25 November 2019

GPs have voted for pharmacists to be given powers to dispense an equivalent preparation or dosing regime when the prescribed medication is unavailable, without returning the prescription to the GP.

GPs in England have voted to allow pharmacists to substitute an appropriate alternative when a medication is in short supply. | GETTY IMAGES

The BMA's GP committee will support a policy of giving pharmacists the ability to identify appropriate and available alternatives to medicines that are in short supply, following a vote at the LMC England conference last week.

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The BMA had previously said it was 'not appropriate' for pharmacists to change patients from one drug to another without authorisation from a prescriber.

The conference motion was put forward by Shropshire and Telford LMC, which demanded that GPC England explore 'changes, including legislation, to make pharmacists responsible for identifying appropriate and available alternatives' when medications are not available.

Pharmacists are currently only able to substitute alternative doses or presentations without referring to the GP when a serious shortage protocol (SSP) has been issued by the government. SSPs have so far only been issued for fluoxetine and only one remains in force, allowing pharmacists to supply 10mg and 20mg capsules in lieu of 30mg capsules.

Describing SSPs as 'very limited and very restricted', Dr Ray McMurray, GP workforce lead for Shropshire LMC, argued that 'with worsening shortages, the criteria should be relaxed and the list extended'.

Motions submitted ahead of the LMC conference condemned the 'increasing frequency' with which commonly used drugs are becoming unavailable, calling for acknowledgment of the 'disastrous' effect on GP workload, clarity on the reasons for shortages, and urgent action to ensure adequate medicines supply.