For the prescribing clinic
Notify the Controlled Drugs Accountable Officer (CDAO) at NHS England. Provide details of the incident, the prescription numbers unaccounted for, the quantity, and the prescriber's details, so that an alert can be circulated in case the prescriptions are presented to community pharmacies.
Report any suspicions of fraudulent use to the NHS Counter Fraud Agency.
For private prescriptions specifically, complete a controlled drugs self-declaration form and submit it to the CDAO at NHS England.
Reissuing a replacement
There is no automatic right to a replacement. The decision to reissue a prescription for a controlled drug should be made on a case-by-case basis, taking into account the patient's clinical needs and the potential for misuse.
đď¸ Note: If the prescription is lost or stolen, the incident must be reported to the police and a crime number obtained. A replacement prescription will be issued once with the provision of a police number, but this will not be repeated.
If the Dispensed Medication is Lost in the Post (After Dispensing)
This is even more restrictive. Emergency supplies of Schedule 2 and 3 CDs, for a specific patient, are not permitted either at the request of the patient or a practitioner. There is no legal mechanism for an emergency replacement supply of Schedule 2 or 3 CDs.
For Schedule 4 and 5, while emergency supply rules are slightly more flexible, the same clinical judgement and diversion-risk assessment would apply.
Summary table
Situation | Requirement |
Prescription lost in post | Notify CDAO; complete self-declaration form; report to police; alert circulated to pharmacies |
Replacement prescription | Case-by-case clinical decision; police crime number typically required |
Dispensed Sch 2/3 meds lost | No emergency replacement permitted in law |
Fraud concerns | Report to NHS Counter Fraud Agency |
đď¸ Note: The overarching principle is that lost CD prescriptions are treated as a patient safety and diversion risk incident, not simply an administrative inconvenience. Both the prescriber and pharmacy have a duty to report and document, and reissuing is never automatic, particularly for Schedule 2 and 3 drugs.