Emergency Supply Service Issues

Emergency Supply Service Issues

September 22, 2017

Problems for patients trying to access Pharmacy First Emergency Supply service after NHS111 referral.

Could this have happened at your pharmacy?

Do all of your locums know that you are signed up and therefore expected to offer this service during all of your opening hours?
This includes when the GP practice is open if it will not be practical for a patient to get an urgent prescription.

The Pharmacy First Services are jointly commissioned by NHSE and all 8 CCGs in Staffordshire and Shropshire.

The LPCs have worked with NHS England and NHS111 to get this service on the referral pathway at NHS111 to reduce the number of people attending OOH and A&E when they have run out of medication.


1. Unfortunately we have now had several reports from NHS111 and the CCG Urgent Care Manager of pharmacies refusing to operate the service because they have a locum there who is not aware of the service.
If you sign your pharmacy up to the service it is your responsibility to ensure that all of the locums you use are aware of the service and will provide medication where appropriate.
(Please note, the issue is not a refusal after making a professional judgment, these are blanket refusals to engage in offering the service, both at weekends and twice on the last Bank Holiday).

2. Several patients have reported back that after an NHS111 referral to a pharmacy for the Pharmacy First Emergency Supply Service they have had to pay for medication even though they are exempt from prescription charges.
This seems to imply that, despite being signed up to operate the Pharmacy First Emergency Supply Service, the pharmacy has made the supply outside the Pharmacy First Service.

This is NOT what NHS111 believe they are referring patients into.
I have asked for specific examples so that I can speak to any pharmacy involved to understand why they did not supply under the Pharmacy First Service.

If this is a case of needing to educate your locums please do so ASAP


Traditionally the referral rate from NHS111 was low compared to self-referral etc, however due to the pressure on urgent care systems NHSE, CCGs, LPCs and NHS111 have been working hard to increase the rate of referrals.

There have been a couple of instances of locums contacting Andy at NHS England and questioning why the pharmacy is using the service and costing the NHS money – the truth is that attendance at OOH or A&E cost much more than if the pharmacy supply under this service.  And what about the cost to patients’ health if they go without vital medication?

The service is there to be used – it helps patients, it is free to those who are exempt from prescription charges and because the NHS pay for the medication there is no need for the patient or pharmacy to “demand” a prescription to cover the supply.  The patient can be supplied with up to 14 days worth of medication and this gives time for their repeat prescription to be ordered in the normal way.  The GP practice is informed of medication supplied under the service via a message from PharmOutcomes.

We are in danger of losing this referral pathway if NHS111 call handlers can not be confident that the referral will result in patients receiving the service.


  • Is your pharmacy signed up to offer this emergency supply service?
  • Do you offer it over all of your opening hours? – if not you need to investigate why and ensure that you do offer it over all of your hours.
  • Do you wish to withdraw from the service? Let Andy Pickard and your LPC know so that you are taken off the referral lists.
  • Do you need any help or support to ensure that you are offering the service correctly?

Thank you for your help with this, if you have any questions or anything to feedback to me (I can certainly share any insights with NHS England and NHS111) please do get in touch with me on my email address: gill@southstaffslpc.co.uk

Best Regards
Gill Hall. 
Service Development Officer gill@southstaffslpc.co.uk

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