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How to prevent common
endorsing errors
Generic items included in Part VIII
of the Drug Tariff continues to be the most significant
area where unnecessary endorsements are added by contractors
(see our article headed 'Information
for pharmacy contractors on the sorting, submission
and endorsement of prescription forms').
A common area where the PPD is unable
to accept endorsements made by pharmacy contractors
relates to prescriptions where the strength, number
or quantity is not stated by the prescriber. General
guidance on prescribing is contained in the BNF on the
action pharmacists should take when an incomplete prescription
for a systemically administered preparation (other than
for a controlled drug) is received. The BNF guidance
covers situations where the prescriber has been contacted
but it has not proved possible to obtain the prescriber's
written intention (p.c.) and those situations where
the prescriber cannot be contacted (p.n.c.).
How should prescriptions be endorsed
in these circumstances?
Strength not stated by the prescriber
and :-
- the prescription item has more than
one strength
- the strength is not stated by the
prescriber
- the pharmacist endorses that the
larger strength has been dispensed
in these cases the prescription must also
be endorsed by the pharmacist either p.c. or p.n.c.
(and initialled and dated) without
either of these endorsements, the PPD is unable to accept
the larger strength as added by the pharmacist and is
required to return the form.
Action needed by pharmacists:
ensure that p.c or p.n.c is endorsed (and
initialled and dated).
Number or quantity not stated by
the prescriber
- the number or quantity is not stated
by the prescriber
- where the prescriber is contacted,
the number/quantity should be added by the pharmacist,
with p.c. (and initialled and dated)
- where the prescriber cannot be contacted,
the pharmacist may supply sufficient to complete up
to 5 days treatment (with the exceptions as outlined
in the BNF). The number/quantity should be added by
the pharmacist, with p.n.c. (and initialled
and dated)
- without either of theses endorsements,
the PPD is unable to accept the number/quantity added
by the pharmacist and is required to return the form.
Action needed by pharmacists:
ensure that p.c. or p.n.c. is endorsed
(and initialled and dated).
Situations where the use of p.c.
or p.n.c. is not an acceptable endorsement
The convention of using the p.c.
or p.n.c. endorsement relates to systemically
administered preparations (other than controlled drugs)
where the strength, number or quantity is not
stated by the prescriber. An endorsement of p.c.
or p.n.c. cannot be accepted by the PPD when
e.g.:
- A different presentation has been
dispensed to that prescribed, for example tablets
x prescribed which are available in two presentations
non-modified release and modified release. The use
of p.c. to supply the modified release cannot be accepted
by the PPD and instead the prescriber's endorsement
is needed
- A different drug/appliance/dressing
has been dispensed to the one prescribed.
Action needed by pharmacists:
the prescriber's endorsement is needed in circumstances
where the pharmacist dispenses a different presentation
or different item to that ordered by the prescriber.
Your usual PPD contact processing division team leader or the PPD Pharmaceutical Directorate will be pleased to provide advice on the different types of endorsements that are needed. You can contact the Pharmaceutical Directorate on 0191 203 5275.
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