Yes, prescriptions for Schedule 2, 3 and 4 CDs are only valid for 28 days from the appropriate date (i.e. date of signing unless the prescriber indicates a date before which the CD should not be dispensed). A start date, even if more than 28 days after the date of signing issue, will ensure the prescription is still valid. The pharmacist will not be able to supply the prescription before the start date or date of signing/issue.
The relevant guidance can be found here:
Dispensing Prescriptions for Controlled Drugs Fact Sheet
And from page 277 in the Orange Guidelines:
Drug misuse and dependence: UK guidelines on clinical management
The prescription should not be dispensed as it is not legally valid. The duty worker should be contacted on the direct number that is printed on the prescription(s) for advice.
No – you should contact the duty/key worker using the contact number on the prescription as soon as possible to notify them of the missed collections, including the last date you did dispense. Please take note of who you have spoken to by phone.
Patients will need to attend the hub for a review and this will then be discussed with a prescriber. Nottingham Recovery Network (NRN) will then contact the pharmacist to confirm that dispensing can resume. If you are in any doubt about the legitimacy of the call then please call NRN and ask for the duty worker to confirm a restart has been agreed. Please note unless there is to be a change of supervision or dose we will not usually issue a new prescription.
The small writing at the bottom of the prescription indicates that in the event of a 3 day miss you should consult a prescriber (NRN). Once done and agreed, dispensing can be resumed from that prescription. The duty worker will be able to supply the name of the prescriber who has approved the restart.
Please check the small writing at the bottom of the prescription for special instructions e.g. split dose / TTO.
Yes, this is possible. The process should be that the patient contacts the key worker/duty worker to discuss the request and reasons for it. This will then be approved by a prescriber and communicated to the pharmacist. The patient should then sign and date a letter naming the nominated person which the person will bring to the pharmacy along with ID.
The Orange guidelines state: “Where the prescriber’s intentions are clear, pharmacists are permitted to make minor technical amendments to CD prescriptions for Schedule 2 or 3 drugs. The error must be a minor spelling or typographical error or the omission of either words or figures in the total quantity (but not both). The pharmacist making the amendment must amend the prescription in ink branding and what they can and cannot dispense dependent on what is written”.
There will be a duty worker who can answer your queries or take messages from 8:30am until 6:00pm Monday, Tuesday, Thursday and Fridays, Wednesdays 8:30am until 7:00pm and Saturdays 9:30 – 12:00pm. The direct number to the duty worker is printed on the prescriptions.
You should avoid using stigmatising language and respect the person’s privacy and dignity. The resource below can help you understand stigmatising language.
Words Matter! Language Statement & Reference Guide
Consultation rooms are now a requirement of all pharmacies providing NHS pharmaceutical services, because of the increased clinical role of pharmacists in providing these services. Where appropriate, pharmacists should use these rooms to support patients who are accessing substance use services. People should not usually be required to use separate entrances or queues, though they may choose to do so.
Everyone should be treated with compassion and understanding and not judged if they relapse and use drugs and alcohol again.
You should inform Nottingham Recovery Network immediately if there are concerns about:
- Changes in a person’s presentation (such as intoxication)
- Safeguarding issues
- Missed doses during titration period
- Missing 3 consecutive doses of opioid substitute medication
- Sporadic attendance
- Unusual non-attendance
Good practice would be to take the name of who you have spoken with and followed up with an e-mail.
Please contact The Health Shop on 0115 905 5001 and a team member will be able answer your questions. Alternatively, you can e-mail healthshop@nottshc.nhs.uk.
Please contact The Health Shop on 0115 905 5001 and a team member will be able answer your questions. Alternatively, you can e-mail healthshop@nottshc.nhs.uk.
