Alamy.com
Community pharmacists should have the same flexibility as those in secondary care when it comes to supplying alternatives strength or formulations of medicines, the Royal Pharmaceutical Society (RPS) has said.
The RPS made its recommendations in its response to a Department of Health and Social Care (DHSC) consultation on enabling pharmacist flexibilities when dispensing medicines, which asks for views on whether community pharmacists should be able to supply a different strength or formulation of the same medicine originally prescribed, if the exact item on the prescription is not in stock.
The DHSC proposed that, in some situations where it does not have the exact product ordered on a patient’s prescription, a pharmacy may hold another item which can provide the same treatment and regime, albeit of a different strength or formulation.
The consultation, which closes on 11 December 2025, asks if community pharmacists should be able to supply this alternative without requesting a new prescription.
In its response, the RPS pointed out that community pharmacists in Scotland can already do this and “no comparative increase in prescribing costs has been reported”.
The DHSC proposals would allow community pharmacists this flexibility if there is an urgent need for the medicine and if the alternative provides the same medicine at the same dose, dosage regimen and treatment cycle as originally prescribed.
The RPS has been calling for these changes for several years, including in its ‘Medicines shortages: solutions for empty shelves‘ report, published in November 2024.
However, it said that the consultation does not cover generic substitution, which would allow pharmacists to provide an alternative generic medicine or a different brand when a specific brand has been prescribed.
It described this as a “missed opportunity for patient care and fully utilising the skills of pharmacists”.
“In the case of ‘branded generics’, where medicines shortages are known to occur and prescribers themselves will routinely amend prescriptions to a generic alternative to maintain continuity of supply for patients, community pharmacists should be enabled to exercise flexibilities, after a consultation with a patient,” its consultation response said.
Claire Anderson, president of the RPS, commented: “This consultation is a landmark moment for pharmacy and patient care. We’ve long campaigned for pharmacists to be empowered to use their professional judgement in the face of medicines shortages, and it’s great to see progress being made.
“The final proposals must be practical and truly enabling. Pharmacists are highly trained clinicians, and unnecessary bureaucracy must not stand in the way of providing patients with timely access to the medicines they need.
“Measures that empower pharmacists to act swiftly and safely will ease pressures across the system and improve patient care.”
In a statement published in October 2025, Community Pharmacy England (CPE) also said it was “broadly supportive” of the DHSC proposals.
“We believe that the ability to use flexibilities should be the norm unless specifically prohibited,” it said.
However, similarly to the RPS, CPE said it wants to see pharmacists being able to use branded generics in these proposed flexibilities.
James Davies, director of research and insights at CPE, said: “CPE, in collaboration with other pharmacy bodies, has long been calling for more flexibility for pharmacists when dispensing medicines subject to supply issues and are pleased to see a positive step forward from the government on this issue.
“There is potential for government to take these flexibilities much further, allowing them to become the norm rather than placing so many restrictions on their use,” he added.
“Community pharmacists are more than capable of handling such scenarios and using their expertise to determine when it is, and isn’t, appropriate to make a change. This would further reduce the costs and workload burden associated with referring patients back to prescribers when a medicine is not available.”
The ‘RPS Workforce wellbeing survey’, results of which were published in February 2025, revealed that 56% of respondents said their mental health had been adversely affected by having to deal with medicines shortages over the past year.
