The Department of Health and Social Care (DHSC) has ‘not made a decision’ on pharmacists being able to supply alternative medications in the case of medicines shortages, health secretary Victoria Atkins has said.

But Sir Chris Wormald, permanent secretary at DHSC, queried whether pharmacists have the ‘skill sets’ and adequate access to a patient’s medical history to make the ‘carefully balanced clinical judgment’ needed to safely supply an alternative medicine.

The comments were made during the parliamentary Health and Social Care Committee (HSCC)’s questioning of DHSC officials yesterday (25 March) afternoon.

HSCC chair Steve Brine suggested that medicines being out of stock was ‘pushing [patients] back to general practice and ‘kind of defeating the object’ of community pharmacists easing GP workload pressures through schemes like Pharmacy First.

‘How big an issue on your desk is medicine shortages? Because I think a lot in the sector would want to hear that it's right at the top of your worry list,’ Mr Brine asked the secretary of state for health and social care.

Ms Atkins responded that ‘the overwhelming majority’ of the 14,000 medicines licensed for supply in the UK were in good supply.

And she said that the DHSC had ‘a very established process’ for issues impacting the medicines supply chain, including working with the pharmaceutical companies involved and issuing serious shortage protocols.

She said that DHSC had ‘not made a decision’ on whether it would expand pharmacy services to allow pharmacists to supply alternative medicines in the case of a shortage.

‘I'm very happy to hear thoughts and evidence on that,’ Ms Atkins added.

Also speaking to the committee, Sir Chris added that supplying a replacement medicine was ‘a very carefully balanced clinical judgement’.

He said that ‘while you want the convenience’ of pharmacists being able to supply an alternative to a medicine that is out of stock, ‘it has to be safe’.

‘There are circumstances where you have to know the whole history of the patient in the way that a GP does to be able to conclude that medicine B will be as effective as medicine A,’ he added.

Mr Brine suggested that giving pharmacists access to patient records that were interoperable with GP systems would achieve this aim.

Sir Chris added: ‘But it also goes with the skill sets of the people involved, so we can’t give you a generic answer, it has to be a clinical decision, case by case.’

Mr Brine responded: ‘If the pharmacy sector was sitting here, they will say, well, "we are the medicines experts". And actually in many ways they are probably more expert on the medicines than the general practitioners.’

Sir Chris said: ‘Yes, but they’re not expert on the patients, and of course, when you’re taking these judgements, you need to be able to do both of those things.

‘You’re absolutely right that we have traditionally underused the skills of pharmacists and we want pharmacists to be able to do more. That’s the whole point of Pharmacy First. But we of course have to balance that with safety considerations.’

Professor Claire Anderson, president of the Royal Pharmaceutical Society (RPS) commented that it was 'welcome' to hear calls for change were being heard by policymakers.

'Pharmacists, patients and GPs continue to share their frustrations with the growing challenge of medicines shortages and their impact on patient care,' she said.

Last month pharmacy minister Dame Andrea Leadsom said the DHSC has ‘no plans’ to allow community pharmacists to amend prescriptions.

In a parliamentary written answer published on 27 February, she said: ‘Allowing pharmacists to take local action to alter prescriptions could have adverse impacts on patients, because pharmacies will not know the reasons why a medicine has been prescribed, or in what particular way.

‘Supplying an alternative without full oversight of supply issues could also create a knock-on shortage of the alternative and could thereby have the potential to exacerbate rather than mitigate a supply problem.’