Tariff Tips

Wednesday 1st October 2014

We have some key Q&A Tariff Tips for you...

Q. I have a prescription for ‘Night bag hanger x 1’- can I dispense it?

A. No this item is not prescribable on the NHS.

Bag stands or hangers are used to hang night drainage bags for the collection of urine. They are considered a nursing aid.

Night-drainage bags are found in the England and Wales tariff under Part IXB Incontinence Appliances, where the following statement is made:

"These bags are suitable for night-time use for the collection of urine from indwelling catheters or incontinence sheaths. They are generally used in conjunction with a bag hanger, which, being a nursing aid is not prescribable. Supply arrangements for bag hangers tend to vary throughout the country but they are normally supplied through the community nursing service."

The same wording is found in Part 5 of the Scotland tariff.

Although no similar wording is apparent in the Northern Ireland tariff, the same principle is assumed to apply.

Q. A customer wishes to purchase Motilium 10 for nausea; can I sell it to them?

A. No. As of 4th September 2014 domperidone has been reclassified as a prescription only medication (POM). It can no longer be sold as a pharmacy (P) medicine. All stocks of P product have now been recalled by the manufacturer.

The MHRA has decided to change the legal status of the anti-motility drug due to difficulties in identifying which patients may be at risk from cardiac side effects. This change follows a review earlier this year by the European Medicines Agency which found that domperidone was linked to a small increased risk of ‘potentially life threatening effects on the heart’

For a full discussion of the issues identified by the EMA review, please see our CPD Module: Drug Safety: Domperidone.

Anyone seeking to purchase domperidone should be referred to the pharmacist for a discussion of their symptoms and possible treatment options.

Patients who have experienced any side effects whilst using domperidone should report them to the MHRA via the Yellow Card scheme.

Q. A methadone patient has an installment due on bank holiday Monday when the pharmacy is closed; can I supply it in advance?

A: Yes you can provided the prescriber has included specific wording on the prescription that authorises a supply when the pharmacy is closed.

In this situation the recognised Home Office wording is:

"Installments due on days when the pharmacy is closed should be dispensed on the day immediately prior to closure"

So in this case, unless the pharmacy is open on Sunday, the day immediately prior to closing would be Saturday. This wording therefore allows Monday’s installment to be supplied on Saturday.

If the pharmacy is open on Sunday, even if only for reduced hours such as a ‘rota’ hour, the installment must be dispensed on Sunday as it is the day immediately prior to closure.

If the prescriber uses their own variation on this wording it will not provide you with the same protection from enforcement when making a supply, and if practical the prescription should be amended by the prescriber to the Home Office wording.

The installment direction on a prescription is legally binding and must be complied with. If the prescriber has not included any wording to authorise a supply when the pharmacy is closed then no supply can be made. The original prescription must be amended or an alternative prescription obtained for the bank holiday supply.