June 19, 2017

The team at PSNC has received a number of queries on the NHS Urgent Medicine Supply Advanced Service (NUMSAS) since the service has gone live. Below are some of the questions asked in recent weeks.

Q.NHS 111 has sent a NUMSAS referral for a patient requesting a Controlled Drug. Why has this occurred?
Generally, NHS 111 call handlers do not conduct an assessment of the legality or clinical appropriateness of the emergency supply request as the majority are not clinicians. Additionally, they are not trained on the Human Medicines Regulations (HMR) to determine what constitutes a valid emergency supply. They will advise patients, when sending a NUMSAS referral, that the pharmacy may decide to make a supply however this will be at the professional discretion of the pharmacist.

Q.What is the appropriate action to take if I receive a referral from NHS 111 for a patient requesting a Controlled Drug?
If it is not possible to make an emergency supply due to prohibitions within the HMR or other factors, but the pharmacist believes that there is a genuine patient need to obtain a supply of their medicine, the pharmacist must contact the local GP OOH service to ensure the patient is contacted by another appropriate healthcare professional. Contacting the GP OOH service must not be delegated to the patient.

Q.How often should we be checking NHSmail for NHS 111 referrals?
NHS England has advised that NHSmail must be ‘regularly’ checked, especially within traditional out of hours periods such as weekday evenings, weekends and holidays, to pick up referrals from NHS 111 in a timely manner. This should include when a pharmacy opens and before the pharmacy closes each day.

‘Regularly’ has not been defined by NHS England in the service specification, therefore it is up to the contractor to determine the appropriate intervals.

Q.Is there a maximum number of medicines or appliances that can be supplied as part of NUMSAS?
No. The pharmacist should apply their professional judgement to determine the appropriateness of supply of each requested medicine or appliance, in line with the provisions of the Human Medicines Regulations.

Q.Is NUMSAS only available out of hours i.e. evenings, weekends and bank holidays (when GP surgeries are closed)?
No. The service must be available throughout the opening hours of the pharmacy (both core and supplementary hours).

More FAQs on NUMSAS can be viewed at

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