Advice on 'Emergency Supply'

The ‘emergency supply’ provisions of Regulation 8 of the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) permit pharmacists, in emergency circumstances, to supply certain prescription only medicines without a prescription. Emergency supply can be carried out at the request of a patient or at the request of a prescriber.

When supplying a medicine under these provisions, it is important that pharmacists are aware of the potential risks, both to the safety and welfare of patients and in the context of their own liability, where medicines are supplied in the absence of an original prescription. Pharmacists should also be aware of their own professional responsibilities as well as those of prescribers.

Emergency Supply of a Prescription Only Medicine at the Request of a Patient

Where the emergency supply is made at the request of a patient, the pharmacist must interview the patient and satisfy themselves that:

There is an immediate need for the medicine
It is not practicable to obtain the prescription without undue delay
The treatment has been prescribed for the patient on a previous occasion
They can safely specify the dose of the medicine for the patient

When assessing the appropriateness of supplying a medicine at the request of a patient, please consider:

1. The patient has not been reviewed or assessed by a prescriber
2. The pharmacist is reliant on information provided by the patient in the course of their decision making process
3. The potential consequences for the patient if an inappropriate medicine is supplied
4. The potential consequences for the patient if the medicine is not supplied
5. Should the pharmacist decide to supply the medicine, that this supply is made without the prior knowledge or approval of the prescriber
6. Doctor on call services are available nationwide and patients may be referred to these services, if appropriate

Please remember:

No more than a 5 day supply of the medicine may be made, or the nearest equivalent minimum dosage pack unit size with the exception of:
- aerosols for the relief of asthma, creams or ointments, where the smallest available size may be supplied,
- the oral contraceptive pill, where a full cycle may be supplied or
- liquid antibiotics, where the smallest quantity that will provide a complete course may be supplied.
To include the words ‘Emergency Supply’ on the label of the dispensed medicine
To document the reason for the emergency supply in the prescription register (daily audit report) and the Patient Medication Record (PMR)
To document the name and address of the previous pharmacy which dispensed the medicine (where different to the pharmacy making the supply) in the prescription register (daily audit report) and PMR

Emergency Supply of a Prescription Only Medicine at the Request of a Prescriber

Where the emergency supply is made at the request of a prescriber (registered medical practitioner, registered dentist or registered nurse presrciber) the pharmacist must be satisfied that:

The prescriber is, by reason of an emergency, not in a position to provide the prescription immediately
The prescriber undertakes to provide the prescription within 72 hours

Please remember

The medicine must be supplied in accordance with the directions of the prescriber
To keep a record that the supply was made at the emergency request of a prescriber
To document the date the original prescription was received from the prescriber into the prescription register (daily audit report).

Controlled Drugs

Pharmacists are not permitted to provide emergency supplies of controlled drugs in schedule 2, 3 or 4 whether at the request of a prescriber or a patient, unless further specific conditions are met in accordance with the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) , including that in the pharmacist’s opinion:

there is an immediate need for the supply of the controlled drug to be made,
it is safe, appropriate, and necessary to make the supply for the continued treatment of the patient,
it is not possible to obtain a prescription without undue delay,
the treatment has previously been prescribed for the patient, and
no more than 5 days treatment or the nearest equivalent minimum dosage pack unit size is being supplied,

request by a patient

an emergency supply of the controlled drug has not already been supplied based on a request by the patient since their last supply on foot of a prescription.

Note: Pharmacists can provide an emergency supply of methylphenobarbitone, phenobarbitone, phenobarbitone sodium, midazolam, clobazam, or clonazepam, at the request of either a prescriber or a patient, without having to satisfy the additional conditions above, where it is for the treatment of epilepsy.

Patients’ Best Interests

It is in patients’ best interests that the emergency supply provisions are reserved for genuine emergency circumstances only. Pharmacists must ensure that complacency surrounding these provisions does not occur and that it is not employed on a regular and routine basis. The importance of regular attendance and consultation with the prescriber should be communicated to patients.

(This was first issued in the PSI Newsletter May 2012 and updated in March 2024)