Use ‘discretion’ when supplying opioid substitution therapy pre-bank holiday
England’s chief pharmaceutical officer David Webb has urged pharmacists to use their “professional discretion” when dispensing opioid substitution therapy (OST) prescriptions in instalments prior to the bank holiday for the Queen’s funeral.
Following news that Monday, September 19 had been declared a bank holiday at short notice, Mr Webb said pharmacies choosing to close for the day should give patients advance instalment supplies of OST “at their discretion”.
Read more: Will pharmacies have to stay open on the Queen's funeral bank holiday?
Patients in need of OST prescriptions are “often vulnerable with multi-morbidities and…the risk to them may be significant”, he said today (September 14).
As such, pharmacists should carefully consider whether to supply patients with their OST dose for Monday before or after the bank holiday, and review “the potential impact” of both options.
This is necessary as not all prescription medicines contain the Home Office approved wording that allows pharmacists to adjust supply around the upcoming bank holiday.
What to do
If pharmacists choose to give patients an additional OST dose to see them through the Monday bank holiday, Mr Webb advised them to ask their local substance misuse service if they agree with the decision, “where possible”.
Pharmacists should also note down any discussions, decisions, and the rationale behind these in the patient’s record.
Mr Webb added that pharmacists should consider supplying the liquid preparation in separate containers for each dose, should they choose to give it to the patient in advance instalments.
Guidance welcomed by charity
Roz Gittins, director of pharmacy at Humankind, said it was “really welcoming to see NHS England providing additional supportive direction” for pharmacists regarding their OST patients.
“We know pharmacies and specialist treatment services are equally stretched and everyone is working their hardest to reduce the risk of people who are opioid dependent inadvertently doses of their medication over this bank holiday weekend,” Ms Gittins added.
She described Mr Webb's guidance as “a useful reminder to pharmacists about our ability to use our professional discretion when making the care of vulnerable people our priority”. Such guidance “encourages a more cohesive approach” between pharmacists and substance misuse services to address similar situations with patient care.
