Dosette boxes, also known as ‘trays’, ‘blister packs’ or ‘multi-compartment compliance aids’ are containers which have separate compartments for days of the week and times of the day and can assist people with taking their medicines.

 

The GP practice must follow certain rules and guidance regarding medications, and the ICB guidance on dosette boxes (or multi-compartment compliance aids /MCA) has changed. The guidance can be found at; download (hweclinicalguidance.nhs.uk).  

 

The change in guidance means that the decision to issue medications in a dosette box is one made by the community pharmacist and no longer by primary care (the GP).

 

This means the surgery cannot provide you with a dosette box anymore, even if you did previously have one set up.

 

 

Dosette boxes are not suitable for all medicines and are not always available for free.

The community pharmacist who dispenses your medicines will need to assess your situation to determine whether you may benefit from a dosette box or other support. The decision is not up to the GP practice, social care or any other agency.

To make this decision, your community pharmacist is expected to undertake an assessment with you. This includes questions about:

 

These questions will support the community pharmacist to determine whether you may be covered under the Equality Act (2010) which legally requires pharmacies to make reasonable adjustments if appropriate. Reasonable adjustments can include: use of large print labels, provision of non-clicklock caps, medication reminder charts, dosette boxes.

 

Historically dosette boxes were supplied free of charge to anyone requesting one but this became unsustainable and too expensive for pharmacies.

Now the only requirement for a dosette box to be supplied free of charge is if you qualify under the Equality Act (2010) and if a dosette box is deemed the most appropriate reasonable adjustment by the community pharmacist.

To qualify under the Equality Act (2010) for a reasonable adjustment, a person is regarded as having a disability if they have a physical or mental impairment, which has a substantial adverse effect on that person’s ability to carry out day to day activities. Additionally, the impairment must be either long term (lasted more than 12 months) or is likely to last more than 12 months or for the rest of the person’s life (for example multiple sclerosis). 1

For those who do not qualify under the Equality Act (2010), community pharmacies can decide to charge for the supply of a dosette box as a ‘private transaction’ or may not offer this as a private service. This fee varies between participating pharmacies and is beyond the GP practice’s control.

 

As detailed above, pharmacies are legally obliged to make reasonable adjustments for those who qualify under the Equality Act (2010). Pharmacies are therefore responsible for completing an assessment for you if a medicine compliance need has been identified to determine whether you qualify.

Pharmacies should not say they do not do dosette boxes as a blanket rule without any individual assessment. If this is happening, you should address this legal obligation with the responsible pharmacist/ pharmacy manager at the branch or head office.

Alternatively, you can also ask another pharmacist if they can provide a Dossett for you.

The GP practice is unable to change or influence any decision a pharmacy makes regarding dosette boxes, and how each pharmacy choose to operate is up to them.

 

Do not return to the GP practice – we cannot amend this.

The pharmacist should have assessed your situation to determine whether you qualify under the Equality Act (2010) for any reasonable adjustments before stopping your dosette box. If this has not happened, you should request this assessment from your community pharmacist.

If you do not qualify under the Equality Act for a free dosette box, your pharmacist should advise you about alternative ways to manage your medicines or may offer you a dosette box and charge for this as part of a private service.

 

You do not need weekly prescriptions for a dosette box, unless your GP has determined this is needed for clinical reasons. It costs the NHS 4 times as much in dispensing fees when supplying weekly prescriptions to Pharmacies compared to supplying them monthly. Weekly prescribing is reserved for a small number of patients due to increased workload and costs to the NHS.

GP practices will not be amending prescriptions to 7 days on the request of a patient or pharmacy for any other reason than a clinical one. Community pharmacies are required to supply medicines for whatever duration is specified by your GP. If you do not qualify under the Equality Act and a pharmacy decides to charge for 28 day prescriptions but not 7 day prescriptions, this is up to them as a business. Unfortunately, it is not the responsibility of the GP practice to make this free by making this an expense to the NHS and pharmacies should not be encouraging us to do this.

 

This depends on the pharmacy; please contact them to discuss arrangements.

 

If you don’t feel that you have been assessed in the way that has been described, please contact the community pharmacy in question and ask to speak to the pharmacist or manager and if necessary as a last resort, ask about their Complaints Procedure.