Emergency regs on flexible provision of services by pharmacies and dispensing doctors

Emergency regs on flexible provision of services by pharmacies and dispensing doctors

April 16, 2020

The Department of Health and Social Care (DHSC) has recently confirmed that contractors may use relevant provisions in the terms of service on temporary opening hours and closures during an emergency requiring flexible opening hours (NHS Regulations), which permit, for example, community pharmacy contractors to give 24 hours’ notice to NHSE&I of temporary flexible opening days and hours, or temporary closures and, if NHSE&I agrees, or at least if it does not object, to implement the changes. Details of the provisions can be found at articles on flexible opening hours during the outbreak and temporary closures during the outbreak.

The NHS Regulations provide that where the Secretary of State declares an emergency, relevant regulations are ‘activated’ and may be used by contractors, and the Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) Directions 2020 declared an emergency requiring the flexible provision of pharmaceutical services with effect from 27 March 2020. Direction 2 states that until 1 July 2020 NHS England must exercise its functions, or where it has discretion, to consider exercising its functions, under NHS regulations:

  • regulation 29(2) (contractors – relocation of premises)
  • regulation 61 (dispensing doctors)
  • paragraph 27 of Schedule 4, (contractors – temporary flexible provision of hours and or closures)
  • paragraph 17 of Schedule 5, and (appliance contractors)
  • paragraph 26(3) of Schedule 7 (LPS pharmacies)

PCC has also issued a helpful briefing on the flexible provision of pharmaceutical services during the current pandemic, which can be found here.

Dispensing Doctors

The emergency provisions of regulation 61, which are applicable to dispensing doctors, seek to ensure the adequate provision of pharmaceutical services in an area if any pharmacies nearby temporarily close. The regulation provides that during the emergency period, currently until 1 July:

  • where there is a temporary closure of a pharmacy in the area of the relevant HWB;
  • and in order to secure continuing adequate provision of pharmacy services and medicine supplies;
  • it is necessary for the dispensing doctor to provide ‘pharmaceutical services’ to normally ineligible patients (dispense prescriptions to those patients who usually have prescriptions dispensed at the pharmacy)
  • for a specified period of time (not longer than the emergency period)

NHSE&I may allow the dispensing doctor practice to dispense medicines temporarily to normally ineligible patients.

The provision is permissive only, and NHSE&I may not give such permission to a dispensing doctor even if a nearby pharmacy closes temporarily. For example, if the provision of pharmaceutical services by other pharmacies in the area provides adequate ‘pharmaceutical services’ in the area, there would be no reason for NHSE&I to give the dispensing doctor such permission.

Regulation 61 while ‘activated’ during the emergency period, does NOT give any authority for dispensing doctors to dispense medicines temporarily to ineligible patients:

  • unless a nearby pharmacy has closed temporarily (this does not include flexible opening hours/closed door working) AND
  • unless and until NHSE&I has agreed that the dispensing doctor may do so (a dispensing doctor does not have to agree to provide such temporary services).

Regulation 61 also allows NHSE&I to grant a dispensing doctor temporary premises approval in appropriate circumstances.

If pharmacy services remain open in a rural area – even with the flexible provision of opening hours/closed door working – there should be no reason for the use of Regulation 61 by a dispensing doctor: no reason for NHSE&I to grant such use.

PSNC would expect local LPCs to be involved by NHSE&I if it considers exercising its powers under regulation 61 of the NHS regulations.

For any queries, please contact Gordon Hockey, PSNC’s Director of Operations and Support.

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