Introduction and considerations

This document attempts to answer some of the commonly asked questions about MCAs. Please note that

• Many of the points made in this document reflect the views of the author based on own experience and interpretation of guidance.
• The FAQ is designed with older people in mind and though the principles may be similar, it will have to be adapted for use in children and younger adults.
• Only the courts of law can make a final decision on any issues regarding the Disability Discrimination Act (DDA) 1995 and 2005.
• An assessment tool can help in decision making but will not cover all eventualities in relation to disability, medicines management needs or interventions to support patient

Whenever a pharmacist dispenses a drug they must take responsibility to ensure that they comply with legislation and best practice. This includes dispensing in MCAs. 

The Drug Tariff (a legal document for NHS pharmacy contractors) states that they shall supply in a suitable container any drug which they are required to supply under Part II of Schedule 2 to the Regulations. Usually this means capsules, tablets, pills, etc should be supplied in airtight containers of glass, aluminium or rigid plastics; card containers may be used only for foil/strip packed tablets etc. Although there is no legislative requirement, each container should meet British Standards (BS) specification regarding moisture and light sensitivity in order to preserve the medication (most MCAs have not been tested. A container fee is paid at the average rate of 3.24p per prescription for every prescription supplied (except for oxygen)

If following an assessment and in the best interest of the patient due to specific reasons the pharmacist has made a decision to deviate from using these standard containers, the reasons why should be clearly documented in the patient’s record or care plan. The pharmacist must then ensure that the necessary measures are put in place to ensure the safe handling or use of those medicines.