A post-implementation review of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, has revealed that a small proportion of distance selling pharmacies (DSPs) have been misusing the DSP exemption in order to supply local, rather than national, delivery services.
Analysis of prescription records shows that between May 2016 and August 2017, an average of 6.7% of DSPs only dispensed prescriptions to patients located within 10km.
The review also highlights evidence of prescription direction to some DSPs, with 4.8% of DSPs that dispense more than 1,000 items a month receiving more than 90% of their prescriptions from a single prescriber.
The Department of Health and Social Care (DHSC) should consult on changes to the 2013 regulations to address these concerns, the review recommends, including adding the requirements that DSPs declare any vested or significant interests and that contractors maintain functional websites to detail how their services can be accessed nationally.
The review also suggests that NHS England develops a complaints process to allow suspected breaches to be reported and investigated, and that the DHSC considers how the development and rollout of the electronic prescription service and patient nomination processes could help to mitigate the issue of prescription direction.
Separately, the review recommends that the government conducts a review of 100 hours per week pharmacies to find out who uses these services and consider if any amendments should be made.
Overall, however, the review found that the regulations, which defined a new market entry system and came into force on 1 April 2013, have largely achieved the original policy objectives, including mitigating excessive provision of NHS pharmaceutical services in areas already meeting demand.
The regulations define a system for managing applications for inclusion on the pharmaceutical list; terms of service requirements for community pharmacy contractors; terms of service requirements for other providers of NHS pharmaceutical services; procedures for dealing with fitness to practise for community pharmacy and appliance contractors; and a system of commissioning local pharmaceutical services.
A further review of these regulations will be published by 31 March 2023.