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Managing complaints about prescription direction

‘Prescription direction’ occurs where a patient is directed by their GP practice to a certain pharmacy to have their prescription dispensed. The BMA, Pharmacy Voice and PSNC have published a joint statement stating that prescription direction should not take place. Prescription direction undermines a patient’s right to have a free choice between any community pharmacy, and damages trust and cooperation between healthcare professionals.

 

Prescription direction can take many forms:
  • Staff within GP practices seeking to influence and direct patients to specific pharmacies.
  • Staff within pharmacies nominating patients to their pharmacy without patient consent.
  • Letters with named pharmacies is sent to patients they signed up to GP practice system online services.  
 

NHS England (which manages the contracts with GPs and pharmacies) and the General Medical Council and General Pharmaceutical Council (the professional regulators) all have a role in stepping in to challenge cases of prescription direction. They generally need to hear from patients before they will take action.

 

If you suspect that prescription direction is happening in your area please inform Community Pharmacy West Yorkshire by emailing brief details to: info@cpwy.org.  NB: DO NOT include patient details

 
Suggested actions for you:

If any of your patients complain about undue pressure to use a particular pharmacy, you can use the Your Prescription Your Choice Leaflet to help them to easily register a complaint.

Patients can explain they wish to be treated as anonymously and do not wish for their details to be shared outside of NHSE&I.  

The NHS England complaints process can be found here: https://www.england.nhs.uk/contact-us/complaint/complaining-to-nhse/.

 

If you become aware that a patient has been subjected to prescription direction:

1. Explain that doctors and pharmacists across the country have agreed that this is not the right way to behave – patients should always be free to choose their pharmacy, and no-one should seek to undermine that right.

2.  That if certain GPs or pharmacies locally are behaving in this way, that this needs to be reported so that something can be done to stop it.

3.  Offer them the “Your Prescription Your Choice” form, explaining that it contains information about this problem and gives them the opportunity to report what has happened to them.

4.  Advise them that the back half of the form can be detached and submitted to the appropriate body. They can submit the form themselves, or ask you to do it for them.

5.  Encourage them to complete the form in the pharmacy, and say that you’ll send their form off for them, along with any other forms that you receive, to save them the cost of a stamp or phone call.  The address for submitting complaints can be found here:  https://www.england.nhs.uk/contact-us/complaint/complaining-to-nhse/.  Please note that any complaints posted to the NHS England Leeds office will be forwarded to the customer contact centre to manage the consent process.

 

Please respect the right of patients not to complain if they are uncomfortable in doing so. Please also recognise that you should treat any interactions with patients on this topic as confidential.

 

Once forms have been returned to you, the next steps are:

1.  Send the form to NHS England in all cases.

2.  If there is evidence that a GP may have acted inappropriately, a copy of the form should be sent to the General Medical Council

3.  If there is evidence that a pharmacist or pharmacy company may have acted inappropriately, a copy of the form should be sent to the General Pharmaceutical Council.

4.  We suggest that you keep a log of the forms that you have sent off

 

The full BMA, Pharmacy Voice and PSNC statement on prescription direction is available at: 

http://psnc.org.uk/wp-content/uploads/2013/07/BMA_PSNC_PV_prescription_direction_guidance_October_13.pdf

 

Your Prescription Your Choice Leaflet

 

 

Last Updated: 18th August 2020