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Section 3 – Medicines Governance

These medicines governance arrangements apply to all settings. This covers private practice settings, including where part of your home is your private practice, as well as NHS and other hospital, clinic and occupational health settings. The guidance in this section will apply alongside any organisational policies and/or procedures that the organisation may have in place.

In addition, SCoR members are expected to demonstrate that they meet the Competency Framework for all prescribers10 , currently being updated

Practice Guidance 27: Instructions for supplying and/or administration 

27.1 If you instruct another person to supply and/or administer medicines on your behalf, you must ensure that the individual is educated, trained and competent to do so.

Practice Guidance 28: Dispensing 

28.1 Dispensing is the preparation and supply of a medicine in accordance with the instructions contained within a prescription. Dispensing is generally performed by a pharmacist or pharmacy technician. You must ensure the separation of prescribing and dispensing of medicines whenever possible. You should not normally dispense against a prescription that you have written. Note that supplying a pre-packed medication is not the same as dispensing.

Practice Guidance 29: Storage

29.1 You should ensure all medicinal products are stored in accordance with the information within the Summary of Product Characteristics / Patient Information Leaflet or information found on the label. Some medicines may require refrigerated storage.

29.2 Medicines can only be stored in ‘’lockable business premises‟ prior to delivery to the patient. When not in use, medicines should be stored in lockable containers or cabinets or otherwise returned to a pharmacy department for safe-keeping.

29.3 NHS staff: You must not store medicines at home unless you have the written permission of your employer to do this which describes the exceptional circumstances that require you to store medicines in your home, and you must have suitable lockable storage facilities in place.

Home-based Private practice: You must only store medicines in lockable containers that constitute “lockable business premises” which are within the business part of your premises.

29.4 All storage environments must meet the prevailing storage requirements and it is your responsibility to find out what these requirements are. You must ensure correct storage polices are in place and are being adhered to.

29.5 You must not store controlled drugs under any circumstances.

Practice Guidance 30: Transportation 

30.1 You may transport medicines from the dispensing pharmacy to their place of use. You must display appropriate health and safety information on your vehicle if the medicine requires it eg medical gases.

30.2 Where medicines are left in a vehicle, appropriate security arrangements must be in place. Medicines should be in a secure container, and the vehicle itself must be locked. CDs must be within a locked container which is secured to the vehicle. The vehicle must be locked at all times. 

Practice Guidance 31: Disposal  

31.1 You must dispose of used, partially used and unused medicines in accordance with current legislation and your local employer policy.

31.2 If there is no local employer policy in place, you must return all medicines to a Pharmacist for safe disposal.

Practice Guidance 32: Error reporting  

32.1 If you discover that you have made an error in prescribing, you must take immediate action to prevent potential harm to the patient, and you must report the error as soon as possible according to local protocols.

Practice Guidance 33: Reporting unexpected effects and adverse reactions  

33.1 If a patient experiences an adverse reaction to any medication they have been prescribed regardless of who the prescriber is, you should record this in the patient notes, notify the prescriber (if you did not prescribe the drug) and notify the MHRA via the Yellow Card Scheme immediately. Yellow cards are found in the back of the British National Formulary and also online at https://yellowcard.mhra.gov.uk/

33.2 You should also inform the patient that they can report adverse reactions independently to the Yellow Card Scheme. 

33.3 You can also report adverse reactions via the MHRA website at www.mhra.gov.uk and serious incidents for investigation (previously known as Serious Untoward Incidents) to the National Reporting and Learning Service, using National Framework for Reporting and Learning from Serious Incidents Requiring Investigation http://www.nrls.npsa.nhs.uk

Practice Guidance 34:  Complementary, herbal and homeopathic products. 

34.1 Complementary, herbal and homeopathic products may interact with other medicinal products and/or laboratory tests. You should ensure you obtain, and record, information from the patient as to whether they are using any such products. Where there is evidence that you should do so, you may need to advise that your patient stops using a complementary, herbal or homeopathic product prior to starting taking a conventional medicinal product or undergoing a medical and/or surgical procedure.

34.2 Some herbal and homeopathic preparations are classed as medicines and are classified as POM, P or GSL depending on their action and route of administration. You may only prescribe and/or supply and administer these products in accordance with an appropriate prescribing and/or supply and administration framework. 

34.3 The MHRA regulates other herbal products under the Traditional Herbal Registration (THR) scheme and other homeopathic products under the National Rules Scheme (NRS). Other products may not be subject to regulation of their quality, safety or efficacy. You should only recommend these products if you have suitable education, training and experience to do so.

34.4 The MHRA holds a list of complementary, herbal and homeopathic products that are known to, or may have, interactions with medicinal products and you must be aware of these before recommending that a patient takes a complementary product in addition to, or as a substitute for, any currently prescribed medicine. Some herbal preparations are prohibited or restricted in their use in humans due to known toxic and/or harmful effects, and you must not recommend these products to your patients.

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