What happens
Punctures on the M45: repaired properly, or replaced with a straight answer.
Screws and nails tend to announce themselves on the M45 as a gentle pull on a straight road with little else to distract you. Heading west, if it steers, carry on to J1 and turn into Dunchurch; heading east towards the M1, the first real stop is Watford Gap southbound. Keep the speed down on the way, since miles on a soft tyre grind the inner sidewall until no patch-plug will do.
With the car parked in Dunchurch or at Watford Gap, our fitter takes the wheel off, parts tyre from rim and looks at the casing from the inside, because the outside hides most of the story. BS AU 159 says a patch-plug is allowed if the screw went in away from both tread edges, the M45 screw hole measures 6 mm at most, and no run-flat scarring shows. Fail one test and it becomes a new tyre, priced on the call first.
If the job turns out to be different, see 24 hour tyre service on the M45, emergency tyre replacement or emergency tyre repair.