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Managing Complaints about Prescription Direction

Patients are entitled to make their own decisions about where they want their prescriptions to be dispensed; therefore, if a patient prefers to use a particular pharmacy, the NHS Constitution requires that this preference is respected.

A prescriber must not seek to persuade a patient to nominate a dispenser recommended by the prescriber and that ALL contractors comply with patient choice. 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 gaining clear patient consent.
 

NHS England 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!



Relevant Links

The 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

https://www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/prescription-direction

https://psnc.org.uk/contract-it/pharmacy-regulation/direction-of-prescriptions/

https://psnc.org.uk/dispensing-supply/eps/patient-nomination-of-a-dispensing-site/



Suggested actions for you:

 

Patient Advice 

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.  You may wish to 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.

 

Patients can explain they wish to be treated 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/.

 

 

Your Prescription, Your Choice 

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. 

 

 

 

Last Updated: 7th January 2022