28 days scripts for dosettes

[bobbin]

Thank you for your reply, bobbin!
I have trying to convince the Dr to change to the 7-day scripts but she insists on 28-day scripts. My supervisor is not willing to do with the 28-day scripts! I am in between!

OK, well you can dispense (and deliver) 4 trays at once. Under no circumstances should you agree to provide weekly deliveries against 28 day scripts - this is allowing the pharmacy to be taken advantage of, and you will soon be expected to do it for everyone.

[jacynta]

OK, well you can dispense (and deliver) 4 trays at once. Under no circumstances should you agree to provide weekly deliveries against 28 day scripts.

I guess this is all I can do!!! It's just toooo difficult to please everyone!

[DispenserJosh]

I guess this is all I can do!!! It's just toooo difficult to please everyone!

Pleasing everyone is something we try to do too much I think! As long as the patients happy, I personally don't mind if the local GP has a chip on their shoulder! At the end of the day if you build up a good relationship with the GP's then they will be more helpful. From personal experience, if you get in with the practice managers and get involved with meetings and such, they generally come around to a compromise. Have you tried arranging a meeting with your local practice manager(s)?

We were having trouble with getting scripts amended by our GP's, arranged a meeting, talked it over and by the end of the week we had a great system in place which is yet to fail!

[Fat Rafa]

Always thought with 7 day scripts, should be supplied every 7 days to warrant them. Means patient must be non DDA compliant.

If patient falls under DDA criteria, no compelling reason for GP to supply weekly scripts. Just have to grin and bear it. Also, if this did happen, PCT may take exception.

7 day scripts for non DDA compliant patients, no problem even if supplied weekly or 4 in one go.

Am I wrong with what I have been led to believe up to now ??

[bobbin]

Always thought with 7 day scripts, should be supplied every 7 days to warrant them. Means patient must be non DDA compliant.

If patient falls under DDA criteria, no compelling reason for GP to supply weekly scripts. Just have to grin and bear it. Also, if this did happen, PCT may take exception.

7 day scripts for non DDA compliant patients, no problem even if supplied weekly or 4 in one go.

Am I wrong with what I have been led to believe up to now ??

http://www.psnc.org.uk/pages/disabil..._dda_1995.html

The PSNC says......

"The DDA 1995 & 28 Day Prescribing

Many of the queries that PSNC receives about support for patients who have a disability concern instructions given by prescribers on the prescription, to dispense weekly into compliance aids. The NHS Terms of Service do not impose a requirement to dispense into compliance aids or to dispense in instalments (other than instalment prescriptions for the treatment of substance misusers). Therefore a prescription ordering treatment for 28 days should be dispensed on one occasion. It is for the pharmacy contractor to decide whether it is appropriate to dispense into a compliance aid.

If a prescription for 28 days' treatment is issued for a patient who satisfies the DDA criteria, and the pharmacy contractor decides that the adjustment required is a compliance aid, then 4 x 7 day compliance aids or 1 x 28 day compliance aid should be prepared on one occasion."

This is how I read it......

If the patient falls under DDA criteria, the GP should provide 7 day scripts to patients who require a weekly service because they are unable to cope with getting 4 trays at once, or because their meds are regularly changing. If the GP believes that the patient will cope with getting 4 trays at once, they should provide a 28 day script. GPs have been advised not to write 7 day scripts for DDA eligible patients who only require a monthly service - PCTs do not approve. The pharmacy contract includes funding/fees to cover the supply of compliance aids to DDA eligible patients, but does *not* require us to dispense 28 day scripts in installments. In particular, it is not financially viable to provide 4 deliveries against one 28 day script and there is no contractual or DDA requirement that we do so. If the patient is on delivery, one monthly delivery of 4 trays should be offered.

If the patient does *not* fall under DDA criteria (ie. there is no sensible reason why they actually need a dosette), it is up to you whether you agree to do it. I suppose you could do it if you are quiet and desperate for items, if you are feeling especially nice (!) or if the GP agrees to provide weekly scripts in order to make it worth your while (in fees) and placate the patient. If you don't do it, the patient will no doubt find somewhere else that will. Whether or not losing such a patient is a good or bad thing depends on your point of view. The multiples hate losing any customer! The view of independents is variable and probably more logical.

In any case, if the GP is providing weekly scripts you are supposed to dispense one tray per week, not four at once. If the patient chooses to collect once per month, that would be their choice but if you are getting weekly scripts for a delivery patient, you should deliver once a week.

The contractual funding that a pharmacy receives for providing MDS (DDA compliance) is based on the number of items that the pharmacy dispenses each month, regardless of whether the pharmacy fills 0 trays ....or 600 trays! The Prescription Pricing Division does not know or care how many MDS you actually dispensed. We are currently paid a fee of 6.6 pence per item in order to fund MDS. So, if your pharmacy dispenses 6000 items per month, £396 of your monthly fees is supposed to cover the MDS service (6000 x 6.6 pence /100). This fee is one of the components of the Practice Payment, a fee which is currently set at 77.1 pence per item for pharmacies dispensing over 2360 items per month. This is explained in the Drug Tariff.