Prescription Only Medicines (POMs)

Question 1

The Human Medicines Regulations 2012 - Classification of medicinal products

Answer 1

GSL - General Sale List
Obtainable from any lockable premises e.g. supermarket.
P - Pharmacy medicines
Obtainable only from registered pharmacies with Responsible Pharmacist in supervision
Bought over the pharmacy counter.
POM - Prescription Only Medicines
Obtainable by wholesale dealing
i.e. Need a prescription (normally).

Question 2

How to obtain a POM

Answer 2

Professional person for use in their practice
By wholesale from a pharmacy or wholesaler (signed order / requisition).

Member of the public
Against a valid prescription from a practitioner
As Emergency Supply at request of a doctor or designated prescriber
As Emergency Supply at request of patient
By means of a Patient Group Direction (PGD)

Question 3

“Health” Prescription

Answer 3

valid for 6 months

Question 4

Types of FP10 forms in England - Green

Answer 4

FP10SS- basically anyone that can prescribe but dentist
FP10NC-GP
FP10HNC- hospital unit

Question 5

Types of FP10 forms in England - Blue

Answer 5

FP10MDA-SS- anyone that can prescribe but a dentist
FP10MDA-SP- GP
FP10MDA-SP- independent prescriber and supplementary prescribers
FP10HMDA- hospital unit

Question 6

Types of FP10 forms in England - Yellow

Answer 6

FP10D-dentist

Question 7

Types of FP10 forms in England - Lilac

Answer 7

nurses

Question 8

Types of FP10 forms in England - Pink

Answer 8

private prescribing issuing schedule 2 and 3 controlled drugs dispensed by community pharmacy

Question 9

Prescription Requirements for POM (HMR 2012 p123)

Answer 9

A valid prescription must be:
Signed by an appropriate practitioner in ink
Written (or typed) in indelible ink (can be carbon paper)
Contain the following particulars
Appropriate practitioner’s address
Appropriate date
An indication of the kind of appropriate practitioner giving it (i.e Practitioners Qualifications)
Name, Address & Age (if under 12) of Patient
must not be dispensed more than 6 months after the appropriate date unless:
repeatable prescription, or
CD Rx (28 days).

Question 10

Prescription requirements for a POM - repeatable

Answer 10

A ‘Repeatable’ prescription
“Script” which contains the direction that it may be dispensed more than once
‘REPEATS’ NOT ALLOWED on FP10 (NHS) scripts or any script for a CONTROLLED DRUG (Schedules 2 & 3)
To be dispensed for the first time within 6 months of the appropriate date.
A repeatable script not specifying the number of repeats may be dispensed no more than twice unless it is an Oral Contraceptive which may be dispensed six times within 6 months of appropriate date

Question 11

How is the pharmacy paid for NHS prescriptions?

Answer 11

REIMBURSEMENT + REMUNERATION
REIMBURSEMENT
Payment of costs incurred e.g. drugs
REMUNERATION
Payment for work involved
Prescriptions sent to NHSBSA (NHS Business Services Authority) at end of each month

Question 12

POM records

Answer 12

All supplies of a POM must be recorded except when:
(i) Supply is on NHS script (HEALTH Rx) or any script for an Oral Contraceptive
(ii) A separate record is made in the Controlled Drugs Register
(iii) Sale or supply is by wholesale dealing and the order or invoice relating to the sale is retained for 2 years
(iv) Supply is made in connection with the NHS Drug Testing Scheme
THE ENTRY MUST BE MADE AT THE TIME OF THE SUPPLY OR on the following day

Question 13

What’s a “POM book”?

Answer 13

Prescription only book
A hardbound register kept in a pharmacy
Our APPS dispensing classes currently simulate this

or…
An electronic record which records the same details in an accessible format
Most pharmacies now use this

Question 14

Details of POM records

Answer 14

Record of supply must contain
Date of supply
Name, quantity, form & strength of product supplied
Date on Prescription
Name & Address of Prescriber
Name & address of patient
For second and subsequent supplies on a repeat prescription only require
Date of supply
Reference to the first entry

Question 15

Who can request an Emergency Supply?

Answer 15

Doctor
Dentist
Supplementary prescriber
Community practitioner nurse prescriber
Independent prescriber
Nurse
Optometrist
Pharmacist

Question 16

Emergency Supply at Request of Doctor / Designated Prescriber

Answer 16

Prescriber must undertake to supply prescription within 72 hours
Pharmacist must be satisfied that prescriber unable to furnish script immediately
POM must be supplied in accordance with prescriber directions
POM must not be CD (Schedule 1, 2 or 3 Misuse of Drugs Act 1971)
Except phenobarbital (epilepsy)
Entry must be made in POM Book

Question 17

Record for Emergency Supply at a doctor’s request- POM book entry

Answer 17

. Date of supply
2. Name, quantity, form & strength of medicine supplied
3. Prescribers name & address
4. Patient’s name & address
5. Date on prescription
6. Date on which prescription received

Record must be made within 24 hours of supply

Question 18

Emergency Supply at request of patient

Answer 18

Interview – Pharmacist must be satisfied that
(i) There is immediate need for POM & script cannot be obtained without due delay
(ii) POM has been previously prescribed to patient
(iii) Dose is appropriate
(iv) Professional judgment in the best interests of the patient.
Quantity – Maximum 5 days supply for Controlled Drugs –Phenobarbital and Schedule 4 or 5 CDs and 30 days for other POMs
(i) Insulin, ointment, cream or aerosol spray – supply smallest available pack
(ii) Oral Contraceptive – supply complete cycle
(iii) Liquid antibiotic – Supply smallest complete course

Emergency supply at Patient’s Request is not permitted if:
(i) The POM is a Controlled Drug specified in Schedules 1,2 or 3 of Misuse of Drugs Regulations except for Phenobarbital or Phenobarbital Sodium for the treatment of epilepsy
(ii) The POM is included in a prescribed List

Question 19

Details required for valid PGD

Answer 19

Clinical Condition
Condition / situation defined
Inclusion & exclusion criteria
Cautions
Description of Treatment
Name, Dose, etc
Advice to patient – verbal or written
Records required
Characteristics of Pharmacist or other HCP
Qualifications and training required
Management of PGD

examples
Flu vaccinations in pharmacy
Travel health clinics in pharmacy
Chlamydia treatment