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Monitored dosage systems

NPA Essential

Monitored dosage systems

Leyla Hannbeck, Chief Pharmacist at the NPA, highlights the support for pharmacists who supply medicines in monitored dosage systems

Dealing with dispensing medicines in MDS is an area which often causes confusion for pharmacists and their teams. Many of the Patient Safety Incident report forms that the NPA receives relate to dispensing errors involving many aspects of supply of medicines in MDS.

General Pharmaceutical Council (GPhC) inspectors may look at how pharmacies manage their MDS patients as part of their inspection.

Some of the GPhC standards for registered pharmacies which inspectors most commonly find that pharmacies fail to meet include:

“1.1 The risks associated with providing pharmacy services are identified and managed

1.2 The safety and quality of pharmacy services are reviewed and monitored

1.6 All necessary records for the safe provision of pharmacy services are kept and maintained

3.1 Premises are safe, clean, properly maintained and suitable for the pharmacy services provided

4.3 Medicines and medical devices are: and fit for purpose....stored securely... supplied to the patient safely “

Failing to deal with MDS issues appropriately could result in a failure to meet these standards.

New NPA resources

The NPA has launched new MDS resources. Our pharmacy team has created these resources in response to the numerous queries received from members seeking guidance on various aspects of MDS, from the legal and practical considerations of dispensing medication in this way to finding suitable suppliers for MDS.

The resources include:

  • Guidance – covering the relevant legislation as well as the practical issues of MDS dispensing, including hygiene, labelling of MDS, supplying Medicine Administration Record (MAR) charts and the suitability of medicines dispensed in MDS; the guidance document is also a useful training tool for the pharmacy team
  • Standard operating procedure (SOP) – a comprehensive template SOP that takes into account the risks associated with dispensing in MDS; this can be tailored by NPA members to cover the specific processes in individual pharmacies
  • Suppliers list – provides information on different brands and designs of MDS as well as up-to-date information on MDS suppliers
  • FAQs – a collection of frequently asked questions on a wide range of MDS issues, including for example:

Q: Can I charge a patient for supplying their dispensed medicines in an MDS?
A: This depends on whether the patient is eligible to have their medicines dispensed in an MDS under the Equality Act 2010. If the patient satisfies the Equality Act 2010 criteria and the provision of an MDS is the most appropriate adjustment to be made, the pharmacist must not charge for providing an MDS.

If the patient is not eligible to have an MDS under the Equality Act 2010 but prefers to have one, then the pharmacist would need to decide whether or not to apply a charge, and what the charge levied should be. This would be a business decision and should be agreed by the superintendent pharmacist/ pharmacy owner.

For further information please contact the NPA Pharmacy Services team on 01727 891800 or email

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