Pharmacy profession welcomes dispensing error decriminalisation legislation

New decriminalisation law will improve patient safety, experts agree.


Pharmacy leaders have welcomed new legislation that will protect community pharmacists from prosecution over dispensing errors.

The Pharmacy (Preparation and Dispensing Errors – Registered Pharmacies) Order 2018, laid before Parliament on 14 November 2017, will introduce a new legal defence for community pharmacists and pharmacy staff who make inadvertent dispensing errors.

Ken Jarrold, chair of the Rebalancing Medicines Legislation and Pharmacy Regulation Programme Board, which drew up recommendations to government minsters on the proposed legislation, said a change to the law would increase reporting of errors without fear of prosecution. And he said the emphasis should now be on extending the defence from prosecution to all pharmacists.

“Pharmacy professionals now need to play their part in improving the reporting of errors and maximising learning to improve patient safety and the quality of service,” he said.

“I look forward to the introduction of proposals that put in place similar measures for hospitals and other specified pharmacy settings, and a separate order to clarify the roles of the superintendent pharmacist and responsible pharmacist, which are essential elements to the organisational governance framework in pharmacy.”

Pharmacy minister Steve Brine said the legislation, which is expected to become law before Christmas, would protect pharmacists and “address some of the barriers to providing a safer, high quality service”.

“These changes will give pharmacy professionals a framework to operate within that will improve the reporting of incidents, increase transparency and allow lessons to be learned – this will ultimately improve patient care and reduce the risk of harm,’ he said.

The new legislation means that pharmacists, pharmacy technicians, and pharmacy staff working under their care will have a defence in law as long as they could demonstrate that any errors occurred as part of their work in a registered pharmacy, that they took reasonable steps to notify a patient if a mistake became apparent, and that they were not misusing their professional skills for improper use or not having due regard for patient safety.

General Pharmaceutical Council chief executive, Duncan Rudkin said he looked forward to the UK governments consulting in 2018 on extending the protection against prosecution to other pharmacists.

He added: “We have consistently been clear that single dispensing errors do not in our view constitute a fitness to practise concern, if there is not a wider pattern of errors or significant aggravating factors.”

RPS chief executive, Paul Bennett, said the legal change would “help foster a learning culture, encourage the reporting of errors and ultimately support patient safety”.

“We will continue working with the Rebalancing Board as it seeks to develop similar proposals for hospitals and other pharmacy settings,” he said.

The RPS Council officially began the process of seeking a change to legislation to decriminalise dispensing errors as long ago as 2006.

In February 2015 the four UK governments published a consultation document that proposed amending legislation to include a defence for inadvertent dispensing errors.

Mark Koziol, chairman of the Pharmacists’ Defence Association said his organisation had “consistently advised” Jarrold that defences proposed in the 2015 consultation, which relate to two sections of the 1968 Medicines Act, and on which the current draft legislation is based, would “not on their own” prevent pharmacists from being prosecuted.

“Consequently, we told him that the Board would need to go further and propose changes to other areas of the Act to close down the possibility of prosecution,” he said.

Koziol said the PDA was now undertaking a “detailed analysis” of the proposed legislation before advising its members accordingly.

Other figures from the profession were happier with the proposed legislation.

Source: Courtesy, NPA

Ian Strachan, chair of the National Pharmacy Association, said the changes now before Parliament would help nurture a “culture of openness and transparency”, which in turn underpinned patient safety

National Pharmacy Association chair Ian Strachan described it as a “significant step forward”.

“The application of criminal sanctions for single, inadvertent dispensing errors is grossly disproportionate and the changes now before Parliament for approval will help nurture a culture of openness and transparency, which in turn underpins patient safety,” he said.

“It will be important that prosecutors understand the spirit of what is intended by the change, which is about fairness, proportionality and the fostering of a learning culture”.

John D’Arcy, managing director of Numark said the draft legislation was “much needed to remove a significant practice burden from pharmacists and their teams created by an anachronistic legal provision”.

And Steve Howard, quality & clinical standards director and superintendent pharmacist at Celesio described it as “a significant milestone”.

Source: Simon Wright / The Pharmaceutical Journal

Rose Marie Parr, Scottish chief pharmaceutical officer, said increased error reporting would help improve patient safety

Scottish chief pharmaceutical officer Rose Marie Parr said she “looked forward to more sharing and learning from increased error reporting to help improve patient safety”.

And chief pharmacist for Northern Ireland, Mark Timoney, said the measure would lead to greater patient and public safety.

Sir Kevin Barron MP, chair of the All-Party Pharmacy Group welcomed the arrival of the draft legislation “at long last”, and wished it a “speedy passage through Parliament”.


  • 16 November 2017 — The headline of this article was corrected to read ‘dispensing error decriminalisation legislation’
Last updated
The Pharmaceutical Journal, PJ, November 2017, Vol 299, No 7907;299(7907):DOI:10.1211/PJ.2017.20203947

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