(1) An NHS pharmacist (P) must have access to summary care records at P’s pharmacy premises, and must ensure that the access that P has to summary care records at those premises is constant and reliable during core and supplementary opening hours, in so far as that is within the control of P.

(2) P must access the summary information in a patient’s summary care record whenever P is providing pharmaceutical services to the patient, to the extent that P, in the exercise of P’s clinical judgement, considers it appropriate to do so.

(3) In this paragraph, a “summary care record” and “summary information” mean a summary care record and summary information within the meanings given in—

(a) regulation 68 of the GMS Regulations (summary care records); and

(b) regulation 61 of the PMS Regulations (summary care records).

Inducements etc.

Duty to provide information about fitness matters as they arise

Other information to be supplied

Co-operation with Health Education England

Complaints

Inspections and access to information

Accessing summary care records

13A

(1) An LPS chemist (C) must have access to summary care records at C’s scheme premises, and must ensure that the access that C has to summary care records at those premises is constant and reliable during the hours when the scheme premises are open to the public, in so far as that is within the control of C.

(2) C must access the summary information in a patient’s summary care record whenever C is providing local pharmaceutical services to the patient, to the extent that C, in the exercise of C’s clinical judgement, considers it appropriate to do so.

(3) In this paragraph, a “summary care record” and “summary information” mean a summary care record and summary information within the meanings given in—

(a) regulation 68 of the GMS Regulations (summary care records); and

(b) regulation 61 of the PMS Regulations (summary care records).

Inducements etc

Duty to provide information about fitness to practise matters as they arise

Co-operation with Health Education England

Charges for drugs, appliances and containers, and ownership of containers

Refunds of prescription charges

Remuneration, overpayments etc

Local resolution of disputes

Dispute resolution: non-NHS contracts

NHS dispute resolution procedure

Determination of dispute

Disputes: supplemental

Complaints

Variation of LPS schemes

Termination by agreement

Termination by serving notice

Termination of arrangements by the NHSCB on grounds of suitability etc

Termination by the NHSCB: patient safety and material financial loss

Termination and the NHS dispute resolution procedure

Third party rights

Consolidation onto an existing site

26A

(1) A person already included in a pharmaceutical list may make an application pursuant to this paragraph (“a consolidation application”) in respect of the consolidation onto the site (S1) of listed chemist premises in the area of the relevant HWB (HWB1) of the provision of pharmaceutical services provided at or from S1 and other listed chemist premises (S2) in the area of HWB1.

(2) Section 129(2A) of the 2006 Act (regulations as to pharmaceutical services) does not apply to a consolidation application by a person already included in a pharmaceutical list for inclusion in respect of premises not already listed in relation to that person.

(3) Subject to paragraph (4), a consolidation application—

(a) must be made by the person (P1) included in the pharmaceutical list in relation to S1; and

(b) if different persons are listed in relation to S1 and S2, must include as part of the application an application by P1 to change the ownership of S2.

(4) If different persons are listed in relation to S1 and S2, and the person (P2) listed in relation to S2 is seeking to become the person listed in relation to S1, a consolidation application—

(a) must be made by P2; and

(b) must include as part of the application an application by P2 to change the ownership of S1.

(5) NHS England must refuse a consolidation application—

(a) if it is satisfied that granting the application would create a gap in pharmaceutical services provision that could be met by a routine application—

(i) to meet a current or future need for pharmaceutical services, or

(i) to secure improvements, or better access, to pharmaceutical services; or

(b) if either S1 or S2 are distance selling premises or appliance contractor premises.

(6) In the case of an application to which paragraph (3) applies, NHS England must refuse the application unless it is satisfied—

(a) if NHS England intends to commission from P1 at or from S1 enhanced services which P2 provides at or from S2 but which P1 has not been providing at or from S1, that the provision of those services will not be interrupted except for such period as NHS England may for good cause allow;

(b) in the case of an application to which paragraph (3)(b) applies, that—

(i) P2 consents to the change of ownership of S2, and

(ii) P1 and P2 consent to S2 ceasing to be listed chemist premises as a consequence of the application; and

(c) in the case of an application to which paragraph (3)(b) does not apply, that P1 consents to S2 ceasing to be listed chemist premises as a consequence of the application.

(7) In the case of an application to which paragraph (4) applies, NHS England must refuse the application unless it is satisfied—

(a) that P2 is proposing to carry on at or from S1, in place of P1, the business in the course of which P1 is providing pharmaceutical services at or from S1;

(b) that P2 is undertaking to provide the same pharmaceutical services as those that P1 is providing (whether or not P2 is also to provide other services that P2 is providing at S2);

(c) that the provision of pharmaceutical services at or from S1 is not to be interrupted, except for such period as NHS England may for good cause allow;

(d) if NHS England intends to commission from P2 at or from S1 enhanced services which P2 provides at or from S2 but which P1 has not been providing at or from S1, that the provision of those services will not be interrupted except for such period as NHS England may for good cause allow; and

(e) that—

(i) P1 consents to the change of ownership of S1, and

(ii) P1 and P2 consent to S2 ceasing to be listed chemist premises as a consequence of the application.

(8) If two or more consolidation applications are being considered together, as regards the issue of a gap in provision, as mentioned in paragraph (5)(a), each application may be refused on the basis of the cumulative effect on provision of all the applications being considered together.

Applications for temporary listings arising out of suspensions

Applications from persons exercising a right of return to a pharmaceutical list

Temporary arrangements during emergencies or because of circumstances beyond the control of NHS chemists

Template notice of consolidation

29A

(1) This paragraph applies as regards a notice of decision under paragraph 28 in respect of a consolidation application that is granted, in relation to the person who is—

(a) P1 for the purposes of regulation 26A (P1), if regulation 26A(3) applied to that application; or

(b) P2 for the purposes of regulation 26A (P2), if regulation 26A(4) applied to that application.

(2) NHS England must send with the notice of decision sent to P1 or P2 a template of a notice of consolidation, for P1 or P2 to send to it under paragraph 34A, in which P1 or P2 is to provide the following information (some of which NHS England may have included in the template that it sends)—

(a) the date of the grant of the application;

(b) the address of the premises at or from which pharmaceutical services are no longer to be provided (“the closing premises”);

(d) the address of the premises at or from which pharmaceutical services are to continue to be provided (“the continuing premises”);

(e) the registration number of the continuing premises with the General Pharmaceutical Council;

(f) confirmation that reasonable steps have been taken to advise any patients who have nominated the person listed in relation to the closing premises as their nominated dispensing contractor that their nomination will transfer to the person listed in relation to the continuing premises, if the Electronic Prescription Service is available through those premises, unless they change their nomination;

(g) the date on which the consolidation is to take effect;

(h) a signature on behalf of P1 or P2 (whichever has been sent the template) and the date of the notice.

Third party rights of appeal to the Secretary of State where an application is granted

Conditional grant of applications where the address of the premises is unknown

Changes to the premises specified in an application after its grant but before the listing of the premises

Conditional grant in cases relating to future needs or future improvements or better access

Taking effect of listing decisions: general

Taking effect of decisions relating to business consolidations

34A

(1) This paragraph applies as regards a consolidation application that is granted, in relation to the person who is—

(a) P1 for the purposes of regulation 26A (P1), if regulation 26A(3) applied to that application; or

(b) P2 for the purposes of regulation 26A (P2), if regulation 26A(4) applied to that application.

(2) NHS England may only change a pharmaceutical list to give effect to that decision if P1 or P2 gives NHS England a valid notice of consolidation, in the correct form, informing NHS England of the date on which the consolidation is to take effect in the next 14 days.

(3) A notice of consolidation under this paragraph is in the correct form if it—

(a) includes the information required under paragraph 29A; and

(b) is in the same format as the version of the notice sent by NHS England with the notice of decision under paragraph 28.

(4) A notice of consolidation is invalid unless it is sent to NHS England within—

(a) 6 months of the date on which the applicant was sent the notice of NHS England’s decision under paragraph 28 granting the application;

(b) such longer period—

(i) not exceeding a further 3 months as NHS England may allow, or

(ii) if—

(aa) the grant is appealed by a person with third party appeal rights, or

(bb) P1 or P2 appeals successfully against a decision not to allow a longer period under paragraph (i),

as the Secretary of State may allow when the appeal is determined,

(5) A notice of consolidation ceases to have effect if the Secretary of State receives a valid notice of appeal from a person with third party appeal rights relating to the grant to which the notice of consolidation relates.

(6) Once, having regard to sub-paragraph (4), a valid notice of consolidation can no longer be sent in relation to the grant of a consolidation application, the grant of that application lapses.

Notice requiring the commencement of pharmaceutical services

Appeals to the Secretary of State by the applicant

Charge exemption and remission of charges: declarations and checks

4A

(1) For the purposes of paragraph 4, satisfactory evidence includes evidence derived from a check, known as a real time exemption check, of electronic records that are managed by the NHS BSA for the purposes (amongst other purposes) of providing advice, assistance and support to patients or their representatives in respect of whether a charge is payable under the Charges Regulations.

(2) If D dispenses an electronic prescription, D must send the form duly completed by or on behalf of the patient, if one is required under regulation 4(2)(b) or (3A) of the Charges Regulations in respect of that electronic prescription (which may be the associated EPS token), to the NHS BSA.

Provision of Scheduled drugs

Refusal to provide drugs or appliances ordered

Dispensing doctors issuing prescription forms which may be presented to an NHS chemist

Complaints procedures

Inspections and access to information

Voluntary closure of premises

Transitional provisions in respect of drugs or appliances supplied in accordance with SSPs

119A

(1) This paragraph applies where—

(a) pursuant to paragraph 5A(4)(a) of Schedule 4, paragraph 4A(4)(a) of Schedule 5, paragraph 3A(2)(a) of Schedule 6 or paragraph 3A(4)(a) of Schedule 7, an NHS chemist, an LPS chemist or a dispensing doctor is required to endorse a prescription or an associated batch issue; and

(b) the Secretary of State (or the NHS BSA acting on the Secretary of State’s behalf) is only able, or is also able, to process a claim for pharmaceutical reimbursement in respect of the product being provided if the claim is made using a separate token (“a dispensing token”), which is in a form approved by the Secretary of State for the purposes of making such claims (and for prescription charge purposes).

(2) Where paragraph (1) applies—

(a) to the extent required or permitted by the Drug Tariff, a dispensing token recording the provision of the product is treated as being, as regards that product, the prescription for product reimbursement purposes;

(b) if the manner for recording the provision of the product in the dispensing token is provided for in the Drug Tariff, the recording of the provision of the product in the dispensing token must be in the manner provided for in the Drug Tariff; and

(c) the manner of the endorsement of the original prescription or associated batch issue (where provided for in the Drug Tariff) may vary, depending on whether or not it is to be used for product reimbursement purposes.

(3) Where, by virtue of paragraph (2)(a), a dispensing token is treated as being the prescription for product reimbursement purposes—

(a) paragraph 7(6) of Schedule 4 applies as if the reference to paragraph 5A(4)(a) of that Schedule included a reference, in the alternative, to paragraph (2)(a);

(b) paragraph 6(3B) of Schedule 5 applies as if the reference to paragraph 4A(4)(a) of that Schedule included a reference, in the alternative, to paragraph (2)(a);

(c) paragraph 4B of Schedule 6 applies as if the reference to paragraph 3A(2)(b) of that Schedule included a reference, in the alternative, to paragraph (2)(a); and

(d) paragraph 5(6) of Schedule 7 applies as if the reference to paragraph 3A(4)(a) of that Schedule included a reference, in the alternative, to paragraph (2)(a).

(4) For the purposes of this regulation, “pharmaceutical reimbursement” has the meaning given in paragraph 19(3) of Schedule 7.

Amendments and revocations

Review of these Regulations

Supply in accordance with a SSP

5A

(1) This sub-paragraph applies where—

(a) any person requests a drug or appliance from an NHS pharmacist (P) in accordance with a prescription form or repeatable prescription; and

(b) a SSP has effect in respect of—

(i) the requested drug or appliance, or

(ii) drugs or appliances of a specified description, and the requested drug or appliance is of that description.

(2) Where sub-paragraph (1) applies, P must consider whether it is reasonable and appropriate to supply in accordance with the SSP instead of in accordance with the prescription form or repeatable prescription.

(3) Where sub-paragraph (1) applies, P may provide a different product or quantity of product to the product or quantity of product ordered on the prescription form or repeatable prescription, where—

(a) P is able to do so with reasonable promptness;

(b) to do so is in accordance with the SSP; and

(c) the supply of a different product or quantity of product to that ordered by the prescriber is by or under the direct supervision of a registered pharmacist who is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity of product to that ordered by the prescriber is reasonable and appropriate.

(4) Where P, in accordance with sub-paragraph (3), provides a different product or quantity of product to that ordered by the prescriber—

(a) the registered pharmacist mentioned in sub-paragraph (3)(c) must endorse the prescription or the associated batch issue accordingly (if the manner for making the endorsement is provided for in the Drug Tariff, in the manner provided for in the Drug Tariff), and the prescription or associated batch issue as thus endorsed is treated as being the prescription for product reimbursement purposes (even though the supply is not in pursuance of that prescription); and

(b) if the patient to or for whom the product is provided is on a patient list, and the supply—

(i) by virtue of regulation 226A(5)(c)(iii) of the Human Medicines Regulations 2012 (sale etc. by a pharmacist in accordance with a serious shortage protocol), is of a prescription only medicine that is different to but has a similar therapeutic effect to the product ordered by the prescriber, or

(ii) is of any other type, and the Secretary of State and the person who is, for the time being, the person consulted under section 165(1)(a) of the 2006 Act in respect of pharmaceutical remuneration of NHS pharmacists, acting jointly, have issued and publicised in such manner as they see fit a recommendation to the effect that, for clinical reasons, in the case of supplies of that type, providers of primary medical services should be notified of a supply to a patient on its patient list that is in accordance with a SSP instead of in accordance with a prescription form or repeatable prescription,

P must notify the provider of primary medical services on whose patient list the patient is of the supply in accordance with the SSP instead of in accordance with the prescription form or repeatable prescription.

(5) Where—

(a) sub-paragraph (1) applies;

(b) a registered pharmacist is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity of product to that ordered by the prescriber is unreasonable or inappropriate; and

(c) P is able to supply the product or quantity of product ordered by the prescriber within a reasonable timescale but not with reasonable promptness,

the requirements to act with reasonable promptness in paragraph 5(2) and (3) are to be read as requirements to act within a reasonable timescale.

Urgent supply without a prescription

Preliminary matters before providing ordered drugs or appliances

Providing ordered drugs or appliances

Refusal to provide drugs or appliances ordered

Further activities to be carried out in connection with the provision of dispensing services

Additional requirements in relation to electronic prescribing

Additional requirements in relation to specified appliances

Disposal service in respect of unwanted drugs

Basic procedure in respect of unwanted drugs

Further activities to be carried out in connection with the provision of dispensing services

Promotion of healthy lifestyles

Prescription linked intervention

Public health campaigns

Signposting

Service outline in respect of signposting

Support for self-care

Service outline in respect of support for self-care

Supply in accordance with a SSP

4A

(1) This sub-paragraph applies where—

(a) any person requests an appliance from an NHS appliance contractor (C) in accordance with a prescription form or repeatable prescription; and

(b) a SSP has effect in respect of—

(i) the requested appliance, or

(ii) appliances of a specified description, and the requested appliance is of that description.

(2) Where sub-paragraph (1) applies, C must consider whether it is reasonable and appropriate to supply in accordance with the SSP instead of in accordance with the prescription form or repeatable prescription.

(3) Where sub-paragraph (1) applies, C may provide a different product or quantity of product to the product or quantity of product ordered on the prescription form or repeatable prescription, where—

(a) C is able to do so with reasonable promptness;

(b) to do so is in accordance with the SSP; and

(c) C is of the opinion that supplying a different product or quantity of product to that ordered by the prescriber is reasonable and appropriate.

(4) Where C, in accordance with sub-paragraph (3), provides a different product or quantity of product to that ordered by the prescriber—

(a) C must endorse the prescription or the associated batch issue accordingly (if the manner for making the endorsement is provided for in the Drug Tariff, in the manner provided for in the Drug Tariff), and the prescription or associated batch issue as thus endorsed is treated as being the prescription for product reimbursement purposes (even though the supply is not in pursuance of that prescription); and

(b) if—

(i) the patient to or for whom the product is provided is on a patient list, and

(ii) the supply is of a type in relation to which the Secretary of State and the person who is, for the time being, the person consulted under section 165(1)(a) of the 2006 Act in respect of pharmaceutical remuneration of NHS appliance contractors, acting jointly, have issued and publicised in such manner as they see fit a recommendation to the effect that, for clinical reasons, in the case of supplies of that type, providers of primary medical services should be notified of a supply to a patient on its patient list that is in accordance with a SSP instead of in accordance with a prescription form or repeatable prescription,

C must notify the provider of primary medical services on whose patient list the patient is of the supply in accordance with a SSP instead of in accordance with a prescription form or repeatable prescription.

(5) Where—

(a) sub-paragraph (1) applies;

(b) C is of the opinion that supplying a different product or quantity of product to that ordered by the prescriber is unreasonable or inappropriate; and

(c) C is able to supply the product or quantity of product ordered by the prescriber within a reasonable timescale but not with reasonable promptness,

the requirements to act with reasonable promptness in paragraph 4(2) and (3) are to be read as requirements to act within a reasonable timescale.

Urgent supply without a prescription

Preliminary matters before providing appliances

Providing appliances

Refusal to provide appliances ordered

Further activities to be carried out in connection with the provision of dispensing services

Additional requirements in relation to electronic prescribing

Additional requirements in relation to specified appliances

Signposting

Opening hours: general

Matters to be considered when issuing directions in respect of core opening hours

Determination of core opening hours instigated by the NHS appliance contractor

Temporary open hours and closures during an emergency requiring the flexible provision of pharmaceutical services

Clinical governance

Professional Standards

Inducements etc.

Duty to provide information about fitness matters as they arise

Other information to be supplied

Co-operation with Health Education England

Complaints

Inspections and access to information

Supply in accordance with a SSP

3A

(1) This sub-paragraph applies where, in relation to an order for a drug or an appliance on a prescription form or a repeatable prescription—

(a) a SSP has effect in respect of—

(i) the requested drug or appliance, or

(ii) drugs or appliances of a specified description, and the requested drug appliance is of that description.

(2) Where sub-paragraph (1) applies and D provides a different product or quantity of product to the product or quantity of product ordered on the prescription form or repeatable prescription, in accordance with the SSP—

(a) D must endorse the prescription or the associated batch issue accordingly (if the manner for making the endorsement is provided for in the Drug Tariff, in the manner provided for in the Drug Tariff); and

(b) the prescription or associated batch issue as thus endorsed is treated as being the prescription for product reimbursement purposes (even though the supply is not in pursuance of that prescription).

(3) Where D provides a drug or appliance under this paragraph, D must include in the dispensing label on the packaging of the product, for the patient’s benefit, information to the effect that the product is being supplied in accordance with a SSP, identifying the particular SSP.

Preliminary matters before providing ordered drugs or appliances

Charge exemption and remission of charges: declarations and checks

Checks and records in the case of supply in accordance with a SSP

4B

In a case involving providing drugs or appliances in accordance with paragraph 3A, the references in paragraph 4 to a prescription form or repeatable prescription are to be construed as references to the prescription for product reimbursement purposes, as mentioned in paragraph 3A(2)(b).

Provision of Scheduled drugs

Refusal to provide drugs or appliances ordered

Dispensing doctors issuing prescription forms which may be presented to an NHS chemist

Complaints procedures

Inspections and access to information

Voluntary closure of premises

Supply in accordance with a SSP

3A

(1) This sub-paragraph applies where—

(a) any person requests a drug or appliance from an LPS contractor (C) in accordance with a prescription form or repeatable prescription; and

(b) a SSP has effect in respect of—

(i) the requested drug or appliance, or

(ii) drugs or appliances of a specified description, and the requested drug or appliance is of that description.

(2) Where sub-paragraph (1) applies, C must consider whether it is reasonable and appropriate to supply in accordance with the SSP instead of in accordance with the prescription form or repeatable prescription.

(3) Where sub-paragraph (1) applies, C may provide a different product or quantity of product to the product or quantity of product ordered on the prescription form or repeatable prescription, where—

(a) C is able to do so with reasonable promptness;

(b) to do so is in accordance with the SSP; and

(c) the supply of a different product or quantity of product to that ordered by the prescriber is by or under the direct supervision of a registered pharmacist who is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity of product to that ordered by the prescriber is reasonable and appropriate.

(4) Where C, in accordance with sub-paragraph (3), provides a different product or quantity of product to that ordered by the prescriber—

(a) the registered pharmacist mentioned in sub-paragraph (3)(c) must endorse the prescription or the associated batch issue accordingly (if the manner for making the endorsement is provided for in the Drug Tariff, in the manner provided for in the Drug Tariff), and the prescription or associated batch issue as thus endorsed is treated as being the prescription for product reimbursement purposes (even though the supply is not in pursuance of that prescription); and

(b) if the patient to or for whom the product is provided is on a patient list, and the supply—

(i) by virtue of regulation 226A(5)(c)(iii) of the Human Medicines Regulations 2012 (sale etc. by a pharmacist in accordance with a serious shortage protocol), is of a prescription only medicine that is different to but has a similar therapeutic effect to the product ordered by the prescriber, or

(ii) is of any other type, and the Secretary of State and the person who is, for the time being, the person consulted under section 165(1)(a) of the 2006 Act in respect of pharmaceutical remuneration of LPS chemists, acting jointly, have issued and publicised in such manner as they see fit a recommendation to the effect that, for clinical reasons, in the case of supplies of that type, providers of primary medical services should be notified of a supply to a patient on its patient list that is in accordance with a SSP instead of in accordance with a prescription form or repeatable prescription,

(5) Where—

(a) sub-paragraph (1) applies;

(b) a registered pharmacist is of the opinion, in the exercise of his or her professional skill and judgement, that supplying a different product or quantity of product to that ordered by the prescriber is unreasonable or inappropriate; and

(c) C is able to supply the product or quantity of product ordered by the prescriber within a reasonable timescale but not with reasonable promptness,

the requirements to act with reasonable promptness in paragraph 3(1) and (2) are to be read as requirements to act within a reasonable timescale.

Urgent supply without a prescription

Preliminary matters before providing ordered drugs or appliances

Providing ordered drugs or appliances

Refusal to provide drugs or appliances ordered

Further activities to be carried out in connection with the provision of dispensing services

Additional requirements in relation to electronic prescribing

Further activities in connection with repeat dispensing

Information to be provided for the NHSCB's lists

Clinical governance

Professional Standards

Accessing summary care records

Inducements etc

Duty to provide information about fitness to practise matters as they arise

Co-operation with Health Education England

Charges for drugs, appliances and containers, and ownership of containers

Refunds of prescription charges

Remuneration, overpayments etc

Local resolution of disputes

Dispute resolution: non-NHS contracts

NHS dispute resolution procedure

Determination of dispute

Disputes: supplemental

Complaints

Variation of LPS schemes

Termination by agreement

Termination by serving notice

Termination of arrangements by the NHSCB on grounds of suitability etc

Termination by the NHSCB: patient safety and material financial loss

Termination and the NHS dispute resolution procedure

Third party rights

Issuing breach or remedial notices while a disease is or in anticipation of a disease being imminently pandemic etc.

71A

NHS England must not issue a breach or remedial notice in respect of a breach of a term of service by a NHS chemist in the following circumstances—

(a) as a consequence of a disease being, or in anticipation of a disease being imminently—

(i) pandemic, and

(ii) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement in respect of the prioritisation of services to be provided in, or in any part of, England as part of the health service;

(b) the prioritisation is in order to assist in the management of the serious risk or potentially serious risk to human health;

(c) as part of the announcement, NHS England with the agreement of the Secretary of State has issued advice to the effect that NHS chemists need not comply with a specified term of service—

(i) in the area to which the announcement relates,

(ii) in the circumstances specified in the announcement, and

(iii) during the period specified in the announcement; and

(d) the NHS chemist—

(i) is situated in the area to which the announcement relates, and

(ii) has not complied with the term of service (it being the specified term of service) in the particular circumstances mentioned in sub-paragraph (c)(ii) and during the period mentioned in sub-paragraph (c)(iii).

Payment withholdings: supplementary matters

Removal of listings: cases relating to remedial notices and breach notices

Removal of listings: cases relating to death, incapacity or cessation of service

Voluntary and automatic removal of listings: change of ownership, relocation, temporary provision and voluntary closure

Limitation on withdrawal from pharmaceutical lists while fitness investigations or proceedings are ongoing

Appeals against decisions under Part 10

Suspension of terms of schemes or of enforcement of terms of schemes while a disease is or in anticipation of a disease being imminently pandemic etc.

102A

(1) Any term that is part of an LPS scheme as a consequence of action taken under regulation 102 or by agreement between the parties is temporarily not part of that scheme, in the particular circumstances mentioned in sub-paragraph (c)(ii) and during the period mentioned in sub-paragraph (c)(iii), in the following circumstances—

(a) as a consequence of a disease being, or in anticipation of a disease being imminently—

(i) pandemic, and

(ii) a serious risk or potentially a serious risk to human health,

(b) the prioritisation is in order to assist in the management of the serious risk or potentially serious risk to human health;

(c) as part of the announcement, NHS England with the agreement of the Secretary of State has issued advice to the effect that LPS contractors are not to comply with a specified type of term of LPS schemes—

(i) in the area to which the announcement relates,

(ii) in the circumstances specified in the announcement, and

(iii) during the period specified in the announcement; and

(d) the LPS contractor is situated in the area to which the announcement relates and compliance with the term (it being of the specified type) would, but for the effect of this paragraph, be a requirement of the LPS scheme of the LPS contractor.

(2) NHS England must not take enforcement action, as provided for in an LPS scheme, in respect of a breach of a term of the LPS scheme in the following circumstances—

(a) as a consequence of a disease being, or in anticipation of a disease being imminently—

(i) pandemic, and

(ii) a serious risk or potentially a serious risk to human health,

(b) the prioritisation is in order to assist in the management of the serious risk or potentially serious risk to human health;

(c) as part of the announcement, NHS England with the agreement of the Secretary of State has issued advice to the effect that LPS contractors need not comply with a specified type of term of an LPS scheme—

(i) in the area to which the announcement relates,

(ii) in the circumstances specified in the announcement, and

(iii) during the period specified in the announcement; and

(d) the LPS contractor—

(i) is situated in the area to which the announcement relates, and

(ii) has not complied with the term (it being of the specified type) in the particular circumstances mentioned in sub-paragraph (c)(ii) and during the period mentioned in sub-paragraph (c)(iii).

LPS schemes: health service body status

Development of LPS schemes

Persons permitted to be parties to LPS schemes: fitness criteria

LPS proposals: fitness information to be supplied

Notification of proposals

Right of return to pharmaceutical lists: LPS contractors

LPS pilot schemes: health service body status

LPS pilot schemes: termination

Emergencies requiring the flexible provision of local pharmaceutical services

Directions to the First-tier Tribunal relating to local pharmaceutical services

Lists of LPS chemists

Home delivery service while a disease is or in anticipation of a disease being imminently pandemic etc.

22A

(1) Before dispensing any item on a prescription form or supplying it in accordance with a serious shortage protocol, an NHS pharmacist (P) must provide a home delivery option to eligible patients in respect of the item where, as a consequence of a disease being or in anticipation of a disease being imminently—

(a) pandemic; and

(b) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement to the effect that, in order to assist in the management of the serious risk or potentially serious risk to human health, eligible patients are advised to stay away from pharmacy premises in the area specified, in the circumstances specified and for the duration of the period specified in the announcement.

(2) If P’s pharmacy premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from P’s pharmacy, P must ascertain from—

(a) an eligible patient—

(i) who has contacted P about the home delivery of prescription items, or

(ii) who is a person whom P considered, on the basis of the nature of an item on a prescription form, might be an eligible person and accordingly, in the ordinary exercise of professional skill and judgement, made the appropriate checks and determined that they were; or

(b) a person who may make an application for pharmaceutical services on behalf of that eligible patient (a “duly authorised person”) who has contacted P about the home delivery of prescription items,

whether or not the item could be supplied by a duly authorised person, and if it could, then supplying the item via a duly authorised person is the home delivery option which P must provide.

(3) Where paragraph (2) does not apply, if P’s pharmacy premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from P’s pharmacy, the home delivery option that P must provide must comprise—

(a) P delivering the item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person (for example, a care home where the patient is temporarily residing);

(b) P arranging for an item dispensed by P to be delivered by another NHS pharmacist or by an LPS contractor to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person; or

(c) if P is unable to deliver the item or arrange for its delivery by another NHS pharmacist or by an LPS contractor, P arranging for the dispensing or supply of the item by another NHS pharmacist or by an LPS contractor who would be able to deliver the dispensed item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person.

(4) Paragraph (1) does not apply where the eligible patient or a duly authorised person is already at P’s pharmacy premises for the purposes of receiving dispensing services.

(5) Notwithstanding the foregoing provisions of this Part, in any case of a supply in accordance with a home delivery option, if but for this sub-paragraph that supply would need to be made with reasonable promptness, P may instead, in the exercise of professional skill and judgment, make the supply within a reasonable timescale.

(6) Where arrangements are in place which enable an NHS pharmacist to make a delivery as mentioned in sub-paragraph (3)(a) or (b) as part of a directed service, the NHS pharmacist must deliver the item as part of that directed service.

(7) This paragraph does not apply to an NHS pharmacist in respect of distance selling premises.

Pharmacy opening hours: arrangements while a disease is or in anticipation of a disease being imminently pandemic etc.

27A

(1) Notwithstanding the foregoing provisions of this Part, the core or supplementary opening hours of an NHS pharmacist (P) may be changed by NHS England where, as a consequence of a disease being, or in anticipation of a disease being imminently—

(a) pandemic; and

(b) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement to the effect that, in order to assist in the management of the serious risk or potentially serious risk to human health, NHS England may, in the area to which the announcement relates and in the circumstances specified in the announcement, notify NHS pharmacists of changes to core and supplementary opening hours for the period specified in the announcement.

(2) Where paragraph (1) applies, where NHS England notifies P of changes to P’s core or supplementary hours at P’s pharmacy premises, those are P’s core and supplementary opening hours for the period that NHS England specifies in the notification (unless NHS England notifies P of further changes to P’s opening hours).

Home delivery service while a disease is or in anticipation of a disease being imminently pandemic etc.

7A

(1) Before dispensing any item on a prescription form or supplying it in accordance with a serious shortage protocol, a dispensing doctor (D) must provide a home delivery option to eligible patients in respect of the item where, as a consequence of a disease being or in anticipation of a disease being imminently—

(a) pandemic; and

(b) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement to the effect that, in order to assist in the management of the serious risk or potentially serious risk to human health, eligible patients are advised to stay away from listed dispensing premises in the area specified, in the circumstances specified and for the duration of the period specified in the announcement.

(2) If D’s listed dispensing premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from D’s premises, D must ascertain from—

(a) an eligible patient—

(i) who has contacted D about the home delivery of prescription items, or

(ii) who is a person whom D considered, on the basis of the nature of an item on a prescription form, might be an eligible person and accordingly, in the ordinary exercise of professional skill and judgement, made the appropriate checks and determined that they were; or

(b) a person who may make an application for pharmaceutical services on behalf of that eligible patient (a “duly authorised person”) who has contacted D about the home delivery of prescription items,

whether or not the item could be supplied by a duly authorised person, and if it could, then supplying the item via a duly authorised person is the home delivery option which D must provide.

(3) Where paragraph (2) does not apply, if D’s listed dispensing premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from D’s premises, the home delivery option that P must provide must comprise—

(a) D delivering the item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person (for example, a care home where the patient is temporarily residing);

(b) D arranging for an item dispensed by D to be delivered by another dispensing doctor, or by an NHS pharmacist or an LPS contractor, to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person; or

(c) if D is unable to deliver the item or arrange for its delivery by another dispensing doctor, or by an NHS pharmacist or by an LPS contractor, D arranging for the dispensing or supply of the item by another dispensing doctor, or by an NHS pharmacist or an LPS contractor, who would be able to deliver the dispensed item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person.

(4) Paragraph (1) does not apply where the eligible patient or a duly authorised person is already at D’s listed dispensing premises for the purposes of receiving dispensing services.

(5) Notwithstanding the foregoing provisions of this Schedule, in any case of a supply in accordance with a home delivery option, if but for this sub-paragraph that supply would need to be made with reasonable promptness, D may instead, in the exercise of professional skill and judgment, make the supply within a reasonable timescale.

Complaints procedures

Inspections and access to information

Voluntary closure of premises

Home delivery service while a disease is or in anticipation of a disease being imminently pandemic etc.

10A

(1) Before dispensing any item on a prescription form or supplying it in accordance with a serious shortage protocol, an LPS contractor (C) must provide a home delivery option to eligible patients in respect of the item where, as a consequence of a disease being or in anticipation of a disease being imminently—

(a) pandemic; and

(b) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement to the effect that, in order to assist in the management of the serious risk or potentially serious risk to human health, eligible patients are advised to stay away from listed chemist premises in the area specified, in the circumstances specified and for the duration of the period specified in the announcement.

(2) If C’s listed chemist premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from C’s premises, C must ascertain from—

(a) an eligible patient—

(i) who has contacted C about the home delivery of prescription items, or

(ii) who is a person whom C considered, on the basis of the nature of an item on a prescription form, might be an eligible person and accordingly, in the ordinary exercise of professional skill and judgement, made the appropriate checks and determined that they were; or

(b) a person who may make an application for pharmaceutical services on behalf of that eligible patient (a “duly authorised person”) who has contacted C about the home delivery of prescription items,

whether or not the item could be supplied by a duly authorised person, and if it could, then supplying the item via a duly authorised person is the home delivery option which C must provide.

(3) Where paragraph (2) does not apply, if C’s listed chemist premises are in the area specified in the announcement, during the period when, in the circumstances specified in the announcement, eligible patients need to stay away from C’s premises, the home delivery option that C must provide must comprise—

(a) C delivering the item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person (for example, a care home where the patient is temporarily residing);

(b) C arranging for an item dispensed by C to be delivered by another LPS contractor or by an NHS pharmacist to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person; or

(c) if C is unable to deliver the item or arrange for its delivery by another LPS contractor or by an NHS pharmacist, C arranging for the dispensing or supply of the item by another LPS contractor or by an NHS pharmacist who would be able to deliver the dispensed item to the eligible patient’s home or to an alternative address agreed with the patient or a duly authorised person.

(4) Paragraph (1) does not apply where the eligible patient or a duly authorised person is already at C’s chemist premises for the purposes of receiving dispensing services.

(5) Notwithstanding the foregoing provisions of this Schedule, in any case of a supply in accordance with a home delivery option, if but for this sub-paragraph that supply would need to be made with reasonable promptness, C may instead, in the exercise of professional skill and judgment, make the supply within a reasonable timescale.

Information to be provided for the NHSCB's lists

Clinical governance

Professional Standards

Accessing summary care records

Inducements etc

Duty to provide information about fitness to practise matters as they arise

Co-operation with Health Education England

Charges for drugs, appliances and containers, and ownership of containers

Refunds of prescription charges

Remuneration, overpayments etc

Local resolution of disputes

Dispute resolution: non-NHS contracts

NHS dispute resolution procedure

Determination of dispute

Disputes: supplemental

Complaints

Variation of LPS schemes

Termination by agreement

Termination by serving notice

Termination of arrangements by the NHSCB on grounds of suitability etc

Termination by the NHSCB: patient safety and material financial loss

Termination and the NHS dispute resolution procedure

Third party rights

Subsequent assessments and later first assessments

Condition relating to entering administration

67A

(1) An NHS chemist must, if the NHS chemist enters administration, notify NHS England of that fact.

(2) For these purposes, “enters administration” has the meaning given in paragraph 1(2)(b) of Schedule B1 to the Insolvency Act 1986 (administration).

Conditions relating to local resolution of disputes over terms of service

Supply in accordance with a PTP

5B

(1) Subject to the following provisions of this Part, where—

(a) an NHS Pharmacist (P) receives, via a secure service approved by NHS England for this purpose, an electronic message that amounts to an order for the supply of a drug in accordance with a PTP or a PTPGD ; and

(b) a person who is entitled to be supplied with that drug in pursuance of that order requests the provision of the drug in accordance with that order,

P must, with reasonable promptness, provide the drug so ordered.

(1A) Where P considers—

(a) on the basis of a request for the supply of a drug in accordance with a PTP or a PTPGD that has been approved by NHS England as a basis for supply as part of pharmaceutical services;

(b) having made the appropriate checks; and

that a person is entitled to be supplied with the drug in accordance with the PTP or PTPGD as part of pharmaceutical services, P must, with reasonable promptness, provide the drug requested.

(2) If a person who is entitled as mentioned in sub-paragraph (1)(b) or (1A) asks P to do so—

(a) P must give an estimate of the time when the drug will be ready; and

(b) if they are not ready by then, P must give a revised estimate of the time when they will be ready (until they are ready).

(3) Sub-paragraph (1) does not apply where arrangements are in place for the provision of the drug (whether by P or otherwise) ordered pursuant to the PTP or PTPGD as part of a directed service which includes arrangements for the provision of such a drug ordered in accordance with such a PTP or PTPGD.

(4) Sub-paragraph (1A) does not apply where arrangements are in place for the provision of the drug (whether by P or otherwise) requested in accordance with the PTP or PTPGD as part of a directed service which includes arrangements for the provision of such a drug requested in accordance with such a PTP or PTPGD.

Urgent supply without a prescription

Preliminary matters before providing ordered drugs or appliances

Providing ordered drugs or appliances

Refusal to provide drugs or appliances ordered

Further activities to be carried out in connection with the provision of dispensing services

Additional requirements in relation to electronic prescribing

Additional requirements in relation to specified appliances

Disposal service in respect of unwanted drugs

Basic procedure in respect of unwanted drugs

Further activities to be carried out in connection with the disposal of unwanted drugs

Promotion of healthy lifestyles

Prescription linked intervention

... Health campaigns

Signposting

Service outline in respect of signposting

Support for self-care

Service outline in respect of support for self-care

Home delivery service while a disease is or in anticipation of a disease being imminently pandemic etc.

Flexible provision of relevant immunisation services during a pandemic etc.

27B

(1) Notwithstanding the forgoing provisions of this Part, in order to assist in the management of a serious risk or potentially serious risk to human health which arises as a consequence of a disease being, or in anticipation of a disease being imminently, pandemic, an NHS pharmacist (P) may, with the agreement of NHS England, limit for a specified period (within P’s core and supplementary opening hours) the pharmaceutical services provided at or from P’s pharmacy premises to relevant immunisation services.

(2) If NHS England has made an announcement to the effect that there are particular arrangements under this paragraph that it is prepared to agree, and P limits P’s provision of pharmaceutical services to relevant immunisation services in a manner that is consistent with that announcement, it is to be assumed (in the absence of a contrary notification from NHS England to P) that P has the agreement of NHS England to those arrangements.

(3) In this paragraph, “relevant immunisation services” means directed services that provide for the administration of a medicinal product for vaccination or immunisation against coronavirus or influenza virus in accordance with—

(a) a patient group direction that meets the conditions of regulation 233 of the Human Medicines Regulations 2012 (exemption for supply etc under a PGD by a person conducting a retail pharmacy business); or

(b) a protocol that meets the conditions of regulation 247A of the Human Medicines Regulations 2012 (protocols relating to coronavirus and influenza vaccinations and immunisations),

and for these purposes, “coronavirus” has the meaning given in section 1(1) of the Coronavirus Act 2020.

Electronic Prescription Service access

29B

An NHS pharmacist (P) must have access to the EPS at P’s pharmacy premises, and must ensure that the access that P has to the EPS at those premises is constant and reliable during core and supplementary opening hours, in so far as that is within the control of P.

Contact via NHSmail, pharmacy profiles and the Central Alerting System

29C

(1) An NHS pharmacist (P) must ensure that pharmacy staff at pharmacy premises (including locums) have access to, and are able to send and receive messages via NHS.net Connect from, a premises specific NHS.net Connect account.

(2) P must ensure that at least two members of the pharmacy staff have live, linked NHS.net Connect accounts to the premises specific NHS.net Connect account (unless fewer than two members of the pharmacy staff are engaged in the provision of NHS services).

(3) P must ensure that there is a comprehensive and accurate pharmacy profile in respect of P’s pharmacy premises in the NHS England directory of services, and P must verify and where necessary update the information contained in that profile at least once each quarter of the financial year.

(4) P must ensure that there is a comprehensive and accurate pharmacy profile in respect of P’s pharmacy premises on the NHS.uk website, and P must verify and where necessary update the information contained in that profile at least once each quarter of the financial year.

(5) As regards the Central Alerting System (CAS) operated by the Medicines and Healthcare products Regulatory Agency (MHRA)—

(a) P must register P’s premises specific NHS.net Connect address with MHRA as an address at which P is content to accept notifications as part of the CAS (unless they are content with the address already in the system);

(b) if P changes P’s premises specific NHS.net Connect address, P must immediately notify MHRA of P’s new premises specific NHS.net Connect address, in accordance with paragraph (a); and

(c) P must monitor P’s premises specific NHS.net Connect account with sufficient frequency to ensure the safe and effective supply of medicinal products at or from P’s pharmacy premises, and must act on the alerts P receives as part of the CAS, as appropriate.

Inducements etc.

Duty to provide information about fitness matters as they arise

Other information to be supplied

Facilitating remote access to pharmaceutical services

32A

(1) An NHS pharmacist (P) must, to the extent reasonable—

(a) facilitate remote access to the pharmaceutical services provided at or from P’s pharmacy premises, where users wish to access those services under arrangements that make those services available using remote access; and

(b) establish, maintain and keep under review procedures to facilitate remote access to those services under arrangements that make those services available using remote access.

Co-operation with Health Education England

Complaints

Inspections and access to information

Supply in accordance with a PTP

3B

(1) Subject to the following provisions of this Schedule, where—

(a) a dispensing doctor (D) receives, via a secure service approved by NHS England for this purpose, an electronic message that amounts to an order for the supply of a drug in accordance with a PTP or a PTPGD; and

(b) a person who is entitled to be supplied with that drug by D (Part 8 and this Schedule having that effect) in pursuance of that order requests the provision of the drug in accordance with that order,

D must, with reasonable promptness, provide the drug so ordered.

(1A) Where D considers—

(a) on the basis of a request for the supply of a drug in accordance with a PTP or a PTPGD that has been approved by NHS England as a basis for supply as part of pharmaceutical services;

(b) having made the appropriate checks; and

that a person is entitled to be supplied with the drug by D (Part 8 and this Schedule having that effect) in accordance with the PTP or PTPGD as part of pharmaceutical services, D must, with reasonable promptness, provide the drug requested.

(2) If a person requesting the provision of the drug asks D to do so—

(a) D must give an estimate of the time when the drug will be ready; and

(b) if they are not ready by then, D must give a revised estimate of the time when they will be ready (until they are ready).

(3) Where D provides a drug under sub-paragraph (1) or (1A), D must include a dispensing label on the packaging of the product and include in the label (in addition to the particulars required or permitted by Part 1 of Schedule 26 to the Human Medicines Regulations 2012), for the patient’s benefit, information to the effect that the product is being supplied in accordance with a PTP or a PTPGD, identifying the particular PTP or PTPGD.

(4) Sub-paragraph (1) does not apply where arrangements are in place for the provision of the drug ordered pursuant to the PTP or PTPGD as part of a directed service which includes arrangements for the provision of such a drug ordered in accordance with such a PTP or PTPGD.

(5) Sub-paragraph (1A) does not apply where arrangements are in place for the provision of the drug requested in accordance with the PTP or PTPGD as part of a directed service which includes arrangements for the provision of such a drug requested in accordance with such a PTP or PTPGD.

Preliminary matters before providing ordered drugs or appliances

Charge exemption and remission of charges: declarations and checks

Checks and records in the case of supply in accordance with a SSP

Provision of Scheduled drugs

Refusal to provide drugs or appliances ordered

Dispensing doctors issuing prescription forms which may be presented to an NHS chemist

Home delivery service while a disease is or in anticipation of a disease being imminently pandemic etc.

Complaints procedures

Inspections and access to information

Voluntary closure of premises

Electronic Prescription Service access

13B

An LPS chemist (C) must have access to the EPS at C’s scheme premises, and must ensure that the access that C has to the EPS at those premises is constant and reliable during the hours when the scheme premises are open to the public, in so far as that is within the control of C.

Contact via NHSmail and the Central Alerting System

13C

(1) An LPS chemist (C) must ensure that pharmacy staff at listed premises (including locums) have access to, and are able to send and receive messages via NHS.net Connect from, a premises specific NHS.net Connect account.

(2) C must ensure that at least two members of the pharmacy staff have live, linked NHS.net Connect accounts to the premises specific NHS.net Connect account (unless fewer than two members of the pharmacy staff are engaged in the provision of NHS services).

(3) As regards the Central Alerting System (CAS) operated by the Medicines and Healthcare products Regulatory Agency (MHRA)—

(a) C must register C’s premises specific NHS.net Connect address with MHRA as an address at which C is content to accept notifications as part of the CAS (unless they are content with the address already in the system);

(b) if C changes C’s premises specific NHS.net Connect address, P must immediately notify MHRA of C’s new premises specific NHS.net Connect address, in accordance with paragraph (a); and

(c) C must monitor C’s premises specific NHS.net Connect account with sufficient frequency to ensure the safe and effective supply of medicinal products at or from C’s pharmacy premises, and must act on the alerts C receives as part of the CAS, as appropriate.

Inducements etc

Duty to provide information about fitness to practise matters as they arise

Co-operation with Health Education England

Charges for drugs, appliances and containers, and ownership of containers

Refunds of prescription charges

Remuneration, overpayments etc

Local resolution of disputes

Dispute resolution: non-NHS contracts

NHS dispute resolution procedure

Determination of dispute

Disputes: supplemental

Complaints

Variation of LPS schemes

Termination by agreement

Termination by serving notice

Termination of arrangements by the NHSCB on grounds of suitability etc

Termination by the NHSCB: patient safety and material financial loss

Termination and the NHS dispute resolution procedure

Third party rights

Discharge medicines service

22B

An NHS pharmacist (P) must, to the extent that paragraph 22C requires and in the manner set out in that paragraph, provide advice, assistance and support to and in respect of a health service patient—

(a) recently discharged from hospital who is referred to P for advice, assistance and support in respect of the patient’s medication regimen by the staff of the hospital in which the patient stayed; or

(b) who is otherwise referred to P for advice, assistance and support in respect of the patient’s medication regimen by the staff of an NHS trust or NHS foundation trust as part of arrangements linked to the transfer of care between different providers of NHS services.

Service outline in respect of the discharge medicines service

22C

(1) An NHS pharmacist (P) must have procedures in place (as part of its standard operating procedures) for checking at appropriate intervals on days on which P’s pharmacy premises are open for business whether P has received any referrals, which are in the form and manner approved for this purpose by NHS England, for the services set out in this paragraph (“DMS referrals”).

(2) If P receives a DMS referral in respect of a health service patient (X) requesting from P stage 1 of the service (as well as stages 2 and 3), P must, as soon as possible but in any event within 72 hours of receiving the DMS referral (excluding hours of days on which the pharmacy premises are not open for business), as stage 1 of the service—

(a) review the actions requested, and act on those requested actions, to the extent that P, in the exercise of P’s clinical judgement, considers it appropriate to do so;

(b) use the information that P has or is able to access about X’s medication regimen before the discharge or transfer to compare it (so far as is possible) with X’s medication regimen on discharge or transfer;

(c) check any prescriptions for X that P may be asked to dispense (including electronic repeatable prescriptions) or has part dispensed in order to assess whether, in P’s clinical judgement, any changes are appropriate or there are any other issues of concern;

(d) where necessary, discuss changes that may be appropriate or raise any issues of concern identified, to the extent that P, in the exercise of P’s clinical judgement, considers it appropriate to do so with—

(i) the staff of the hospital or other provider of NHS services that made the referral, and

(ii) any provider of primary medical services on whose patient list X is; and

(e) keep and maintain records of the DMS referrals received and of any actions taken, as appropriate (in particular, to support delivery of stages 2 and 3 of the service).

(3) This sub-paragraph applies—

(a) if P receives—

(i) in respect of X an electronic prescription for a medicinal product or is presented by X with a non-electronic prescription form, a non-electronic repeatable prescription or an EPS token in respect of a medicinal product, and

(ii) is on notice as a result of a DMS referral requesting from P stage 2 of the service (whether or not it is the referral mentioned in sub-paragraph (2)) that the prescription is the first prescription for a medicinal product to be dispensed by P to X following X’s discharge from hospital or the transfer of X’s care between different providers of NHS services; or

(b) in the following circumstances—

(i) P receives in respect of a health service patient (Y) an electronic prescription for a medicinal product or is presented by Y with a non-electronic prescription form, a non-electronic repeatable prescription or an EPS token in respect of a medicinal product,

(ii) P is on notice as a result of a DMS referral requesting from P stage 2 of the service (and potentially stage 3) that it is the first prescription for a medicinal product to be dispensed to Y following Y’s discharge from hospital or the transfer of Y’s care between different providers of NHS services (a different NHS pharmacist having provided stage 1 of the service in respect of Y), and

(iii) P is on notice that Y, or where appropriate a carer of Y, wishes P to provide the services described in sub-paragraphs (4) and (5) to or in respect of Y.

(4) Where sub-paragraph (3) applies, P must, as stage 2 of the service, prior to or as part of the process of dispensing the prescription—

(a) review (or further review) the medication regimen of X or Y, using the information that P has or is able to access about that medication regimen, including from the prescription, in order to assess whether, in P’s clinical judgement, appropriate account has been taken of any changes to X’s or Y’s medication regimen during X’s or Y’s stay in hospital or prior to the transfer of X’s or Y’s care between different providers of NHS services;

(b) if any issues of concern are identified, raise these to the extent that P, in the exercise of P’s clinical judgement, considers it appropriate to do so with any provider of primary medical services on whose patient list X or Y is; and

(c) keep and maintain records of any actions taken as part of this stage of the process, as appropriate (in particular, to support delivery of stage 3 of the service).

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