Richard Hough and Thorrun Govind consider the changes to NHS dispensing that came into effect on January 1, 2025… 

In a significant development for community pharmacists, the Human Medicines Regulations 2012 (HMRs) were amended in October 2023 to introduce original pack dispensing (OPD).

This change followed a comprehensive public consultation and aimed to enhance the efficiency and accuracy of dispensing medications. For NHS prescriptions, these changes came into force on January 1, 2025, as provided for in recent amendments to the terms of service in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (PLPS).

What is original pack dispensing?

OPD allows pharmacists the flexibility to dispense medications in the manufacturer's original packaging. Under the new regulations, pharmacists can dispense up to 10 per cent more or less (+/-10 per cent) than the prescribed quantity if it means the product can be supplied in its original pack.

For NHS dispensing, the OPD rules only apply to prescriptions which are issued electronically via the Electronic Prescription Service (EPS); this includes cross-border Welsh electronic prescriptions.

All FP10 paper prescriptions (including any cross-border paper prescriptions issued in Northern Ireland, Scotland, or Wales and dispensed in England) are excluded from the new OPD rules, so pharmacists will only be able to supply the prescribed quantity (unless the product is classed as a special container).

Community pharmacists and their teams are at the heart of patient care, juggling multiple tasks and responsibilities. This new flexibility in the amount that they can dispense against a prescription is designed to streamline the dispensing process and reduce medication errors.

The rationale is that by dispensing medications in their original packaging, insofar as it is possible, this helps ensure that patients receive the correct medication and dosage, and thereby reducing the risk of errors.

It should in theory also simplify the dispensing process, saving time for pharmacists and patients alike. Receiving medications in their original packaging may also help patients better understand their treatment regimen and improve adherence.

Limitations

While OPD offers significant benefits, it is important to note that there are limitations to its application. Pharmacists must ensure that dispensing medications in their original packaging does not negatively affect the patient's clinical treatment regimen. 

All Prescription Only Medicines (POMs), non-POMs (P medicines, General Sales List (GSL) medicines, non-medicines), and Schedule 5 controlled drugs are within the scope of OPD rules for supply against NHS prescriptions.

However, several products are excluded from the OPD rules for NHS dispensing. These include all Schedules 1-4 CDs, Part IX appliances, unlicensed specials, and products which are classed as special containers.

Whilst the PLPS amendments enable the supervising pharmacist to consider using the OPD flexibility for NHS dispensing from January 1, 2025, there is no requirement to use it.

Pharmacy owners must now consider OPD under the new rules, but the DHSC and Community Pharmacy England state that it is reasonable for pharmacists to opt out of using the OPD provisions until the IT systems have been fully developed and tested to support OPD functionality.

Pharmacists should exercise their professional judgement to assess the suitability of applying the OPD rules, as it may not always be appropriate to supply more or less than the prescribed quantity, particularly to vulnerable patients.

Conclusion

The introduction of OPD marks a positive step forward for community pharmacists, offering greater flexibility and efficiency in the dispensing process.

Those calling for community pharmacists to be able to amend formulations, may argue that it does not go far enough. Nevertheless, by allowing medications to be dispensed in their original packaging, the new regulations are likely to improve accuracy, enhance patient compliance, and streamline pharmacy operations. 

The new rules, which are applicable to the vast majority of NHS electronic prescriptions, are also seen as a fundamental piece of the legislative matrix that will pave the way for increased automation in the dispensing process, and most notably for their potential application within a hub and spoke dispensing model between different legal entities which, as has been widely reported, suffered a particularly disappointing false dawn in the autumn of 2024.

It is hoped by many within pharmacy that this is the removal of the penultimate legislative impediment to such adoption, which may well be the decisive key to unlocking a more service-focused role for pharmacies. The ball is firmly in your court, Stephen Kinnock.

Richard Hough is a partner and head of healthcare at Brabners LLP and a former pharmacist. His co-author Thorrun Govind is a solicitor at Brabners, a pharmacist and TV health expert.