Dispensing & Supply

What are the essential legal requirements for a valid NHS prescription?

• AJust the medicine name and dose
• BPatient name, the date of issue and the prescriber's signature, with no other details required at all
• CPatient name, address, date, medicine details, quantity, dose, and prescriber identification✓
• DPatient name and payment method

Answer: A valid NHS prescription must contain: patient identification, date issued, name/strength/form/dose of medicine, quantity, prescriber details, and prescriber signature.

How long is an NHS prescription valid for dispensing?

• A3 months
• B1 month
• C6 months✓
• D2 weeks

Answer: An NHS prescription in England is valid for 6 months from the date of issue (in Scotland, 9 months for repeat prescriptions).

What is 'repeat dispensing' in NHS pharmacy?

• ADispensing the same prescription multiple times without visiting the GP✓
• BPrescribing a further course of medication each time the same illness comes back
• CA system for reducing dispensing fees
• DGiving the patient extra quantities of an item each time they return to the pharmacy

Answer: Repeat dispensing allows patients to obtain repeat prescriptions without visiting their GP each time, via a single authorisation from the prescriber.

Which information MUST appear on a medicine label following dispensing?

• AOnly the patient name
• BThe storage temperature only, since all other details appear in the patient information leaflet
• CJust the medicine name
• DPatient name, pharmacy name, medicine name, strength, dose instructions, and expiry date✓

Answer: Pharmacy labels must include: patient name, pharmacy details, medicine name, strength, form, quantity, dose instructions, and warning labels/precautions.

What is 'patient counselling' in pharmacy?

• AOnly explaining how to take the medicine
• BPsychological therapy
• CHanding the patient a printed copy of their prescription so that they can read the details at home
• DProviding information about medicines, correct use, side effects, interactions, and storage✓

Answer: Patient counselling involves providing comprehensive information about their medicine including how to use it, expected effects, side effects, interactions, and storage.

Which medicines can be sold Over-The-Counter (OTC) without a prescription?

• ANo medicines at all may be supplied unless a valid prescription is presented first
• BAll medicines, including prescription-only medicines, may be sold from the shop floor
• CMedicines on the General Sales List (GSL) and Pharmacy (P) medicines✓
• DOnly antibiotics, which may be sold without a prescription to treat minor infections

Answer: GSL medicines (e.g., paracetamol, ibuprofen) can be sold freely, and P medicines (e.g., some antihistamines) can be sold in pharmacies under pharmacist supervision.

What is 'emergency supply of a medicine' in community pharmacy?

• AFree supplies during health crises
• BUrgent delivery to hospitals
• CProviding medicines without a valid prescription when the patient's supply has run out and prescriber is unavailable✓
• DSupplying medicines only in emergencies

Answer: Emergency supply allows pharmacists to provide a limited quantity of medicine without a valid prescription if the patient confirms it was previously prescribed and is needed urgently.

What is the maximum quantity of a Pharmacy (P) medicine that can be purchased at one time?

• APharmacist's discretion✓
• BOne pack only, in every case and without exception
• CNo limit at all, provided the customer can pay
• DA maximum of five packs on any single day

Answer: The quantity of P medicines sold is at the pharmacist's discretion based on patient need and responsible supply principles.

Which prescription requirement is aimed at reducing medication errors?

• AAvoiding unnecessary decimals and using leading zeros✓
• BUsing shorthand symbols in place of words to keep the prescription short
• CUsing Latin abbreviations for every dose instruction on the label
• DWriting all strengths in numerals only, including microgram doses

Answer: Best practice includes avoiding unnecessary decimals (e.g., write 5 mg not 5.0 mg) and using leading zeros (0.5 mg not .5 mg) to prevent dosing errors.

What is a 'private prescription'?

• AAn electronic prescription system
• BA prescription paid for privately by the patient rather than through the NHS✓
• CAny prescription written by a doctor who works in the private sector rather than the NHS
• DA prescription whose details the patient asks the pharmacy to keep confidential from others

Answer: A private prescription is one where the patient pays for the medicine directly rather than using the NHS, typically issued by any doctor but paid privately.

Which abbreviation should NEVER be used on prescriptions?

• AIU (international units)
• BOD (once daily)✓
• Cml (millilitres)
• Dmg (milligrams)

Answer: 'OD' (once daily) is on the MHRA 'Do Not Use' list as it can be misread. Instead, write 'once daily' in full to prevent errors.

What is 'dispensing validation' in pharmacy?

• ARegistering the patient on a system
• BA procedure by which the pharmacist ensures the prescription is legal, safe, and appropriate before supply✓
• CChecking the prescription is legal and appropriate
• DJust counting the tablets

Answer: Dispensing validation is the pharmacist's professional check ensuring the prescription is legal, safe, clinically appropriate, and the medicine is suitable for the patient.

What should happen if a pharmacy technician identifies a prescription error?

• AReport it to the pharmacist immediately for review and clarification✓
• BSimply note the discrepancy in the dispensary records and continue with the supply
• CTell the patient to contact their own doctor about it after they have left the pharmacy
• DDispense the prescription as written and let the prescriber pick up any error later

Answer: Any prescription error or discrepancy must be reported to the pharmacist who will contact the prescriber for clarification before dispensing.

Which of the following is a responsibility of the pharmacy technician during dispensing?

• AAccurately counting/measuring medicines and checking against the prescription✓
• BCarrying out the full clinical counselling conversation for every medicine that is supplied
• CCarrying out the final clinical validation of every prescription before it is handed out
• DAuthorising the supply

Answer: Pharmacy technicians prepare and count medicines accurately but the pharmacist must validate. Technicians should support with information but pharmacist handles formal counselling.

What is a 'multi-compartment compliance aid' (blister pack)?

• AA medicine bottle divided into several chambers so that different liquids can be poured separately
• BA storage organiser for tablets at home
• CA packaging to reduce waste
• DA pre-filled pack with individual doses in separate compartments organised by date and time✓

Answer: A multi-compartment compliance aid (e.g., blister pack, Dosette box) organises medicines by date and time to improve adherence, especially for patients on multiple medications.

When should a patient be advised to store insulin?

• AIn a freezer at minus 18°C, and thawed before each injection
• BOn a sunny windowsill so that the insulin reaches room temperature
• C2-8°C until first use, then at room temperature✓
• DAt room temperature from the day of purchase until the expiry date on the carton

Answer: Insulin should be stored at 2-8°C before first use. Once in use, most insulin can be kept at room temperature for about 28 days.

What is an 'adverse drug reaction' (ADR)?

• AAn unwanted effect caused by a medicine at a normal dose✓
• BA medicine that costs the NHS more than the price listed in the Drug Tariff
• CDifficulty in swallowing a tablet because of its size, shape or coating
• DWhen a patient dislikes the taste of a medicine and stops taking it

Answer: An ADR is an unwanted, harmful effect of a medicine that occurs at normal therapeutic doses, distinct from overdose or misuse.

How should pharmacy staff respond if a patient reports a suspected adverse drug reaction?

• AChange their medication without consulting the doctor
• BDocument the report and inform the pharmacist for assessment and potential Yellow Card reporting✓
• CTell them to contact their doctor later
• DDismiss it as unrelated

Answer: Suspected ADRs should be documented, reported to the pharmacist, and if serious, reported via the Yellow Card scheme to the MHRA.

What is 'medication review' or 'medicines optimisation'?

• ACounting tablets
• BA systematic assessment of medicines to ensure they remain appropriate and effective for the patient✓
• CJust checking if medicines are still in date
• DUpdating prescription prices

Answer: Medicines optimisation is a professional service ensuring medicines are appropriate, effective, safe, and taken as intended, improving patient outcomes.

Which NHS service in community pharmacy involves providing contraception advice?

• AThe smoking cessation service, including nicotine replacement supply
• BContraception and sexual health service (CASH)✓
• CThe medicines optimisation service, which reviews long-term prescriptions
• DThe seasonal vaccination service delivered under a national protocol

Answer: Community pharmacies provide contraception and sexual health services including supply of oral contraceptives and emergency hormonal contraception (EHC).

What information should be recorded when dispensing any medicine?

• AJust the patient name
• BOnly the medicine name
• CPatient identifier, date dispensed, medicine details, quantity, prescriber, and validation by pharmacist✓
• DNo records needed for OTC items

Answer: Comprehensive records including patient details, date, medicine details, quantity, and pharmacist validation must be kept for all dispensed medicines.

How long should prescription records be retained in a community pharmacy?

• A2 years✓
• B10 years
• C1 month
• D6 months

Answer: Prescription records should be kept for at least 2 years to allow for audit, follow-up queries, and safeguarding of patients.

What is 'deprescribing'?

• AThe systematic process of withdrawing inappropriate medicines to reduce harm✓
• BStopping every one of a patient's medicines immediately and without any clinical review
• COnly used for elderly patients
• DPreventing patients from ever being prescribed more than three medicines at any one time

Answer: Deprescribing is a carefully managed process of discontinuing or reducing inappropriate medicines to improve outcomes and reduce side effects.

Which law permits NHS prescriptions to be issued electronically?

• AElectronic Prescriptions Service (EPS) regulations under the Health and Social Care Act✓
• BThe Misuse of Drugs Act 1971, which classifies controlled drugs into Class A, Class B and Class C
• CMedicines Act 1968
• DPharmacy Order 2010

Answer: The Electronic Prescriptions Service (EPS) operates under health service regulations, allowing digital prescriptions to be sent directly to pharmacies.

What is a 'serious medication error'?

• AForgetting to charge a patient the NHS prescription levy at the counter
• BA minor typing mistake on a label which does not affect the dose given
• CAn error that causes or has potential to cause patient harm✓
• DAny counting mistake, even where the correct quantity is supplied in the end

Answer: A serious medication error is one that causes actual harm or has significant potential to cause harm to a patient, requiring immediate reporting and investigation.