Since July 2020 the General Pharmaceutical Council (GPhC) has
taken enforcement action against 36 pharmacy premises and a
pharmacy professional following intelligence-led inspections or
investigations relating to unusually high sales of codeine
linctus.
Codeine linctus, classified as a Pharmacy (P) medicine under the
Medicines Act 1968 and the Human Medicines Regulations 2012, can
be only be sold without a prescription from a pharmacy, under a
pharmacist’s supervision. The medicine, which can be used for a
dry cough, is high risk because of well-known problems associated
with its misuse, abuse or overuse.
The pharmacies involved were not adequately identifying and
managing the risks associated with obtaining or selling codeine
linctus. Our unannounced inspections identified that appropriate
safeguards were not always in place to ensure sales were managed
safely and appropriately. There were often insufficient controls
to prevent repeat sales or to identify trends in requests. In
some cases, repeat sales were even made knowingly to the same
people.
Following these inspections, the pharmacies had conditions put on
their registration that they must not sell or supply any codeine
linctus preparations to anyone without an NHS prescription. A
warning has also been issued to the superintendent pharmacist and
regular responsible pharmacist of one of the pharmacies involved.
The individual was found to have allowed the supply of codeine
linctus without sufficient checks and safeguards and relying on
questionnaires and limited clinical information. Fitness to
practise investigations continue into other superintendent and
responsible pharmacist implicated in similar failings.
Claire Bryce-Smith, Director of Insight, Intelligence and
Inspection said:
“Opioids are a high-risk medicine with potential for abuse. We
know that across Great Britain most pharmacies and professionals
have appropriate safeguards in place in order to prevent them
being misused and to provide patients with safe patient-centred
care. Over the course of one year we have taken swift and robust
action against 36 pharmacies and a superintendent pharmacist who
were found not to have these safeguards in place.
“People requesting codeine linctus can be well-rehearsed,
believable or aggressive and will often exploit shift patterns,
relying on poor handover or communication between shifts. We are
asking pharmacy owners and professionals to remain vigilant and
ensure controls are in place to prevent repeat sales or to
identify trends in requests.”
