Nurse prescribers could have their decisions overruled by pharmacists, posing a potential safety risk to patients, under latest proposals.
The Medicines and Healthcare products Regulatory Agency’s proposals to “consolidate and review” UK medicines legislation are included in a consultation which ends next week.
Currently pharmacists can only change the prescribed medicine and directions for use, including the dose, if they have tried and failed to get in touch with the prescriber.
But this could change if the new proposals are implemented. The consultation document proposes the removal of the requirement for a pharmacist “to attempt to seek the prescriber’s permission before making a change”.
However, nurse prescribers warned in some cases pharmacists were likely to make dangerous mistakes if they tried to change prescriptions.
June Rogers, a paediatric continence nursing expert and team director at PromoCon UK, which advises on bladder and bowel services, said she had experienced patients being endangered by pharmacists changing prescriptions, even under the current rules.
She said children and the elderly in particular were often correctly given unusual prescriptions, which pharmacists may try to change. Ms Rogers said the problem would be exacerbated by a change in the law.
Matt Griffiths, an independent consultant nurse and prescribing expert, told Nursing Times pharmacists might replace medicines with generic alternatives, which in some cases could endanger patients.
He said: “People can be quite specific about medicines. Even though something is the same drug generically, it can have a different release profile.”