28 days scripts for dosettes

[Mr Pharm S]

Anyone else been told by their surgery that they are now refusing to do 7 day scripts for dosette patients?

We have had the letter today and as of next month we will get 28 day scripts for our weekly delivery patients.

I have told the surgery that we will therefore only deliver once a month and not weekly.

Do we have the right to start to refuse to do them unless they give us weekly scripts? I feel like doing so. Just another thing they'll badger us down to doing for no fee. Feel like charging the patient to blister the boxes for them so they complain to the surgery only what will happen is Mr Multiple up the road will say theyll do it for free and Pharmacy misses out again! We'll be paying the NHS to dispense before too long! What have things come to?

[johnep]

Join the club, when I pointed out the cost to a surgery, the reply was that chemists get an allowance in the global sum to cover dosettes. The multiple where I was working then advertised that they would supply convenient dose aids for free, and deliver as well.
johnep

[crit care]

would it not be easier to do a 4 week supply at a time rather than 1 a week??

on the flip side it could be more waste, say a patient is admitted to hospital, just as you have boxed up 28days worth of blister boxes, and the hopsital goes and changes all the medication....a waste of medication and even more work for you guys.....

[johnep]

The reason for obtaining weekly scripts is the cost of preparing dosettes. Just time yourself. One minute for 28 days in one box, 28 minutes for 4 dosette boxes with Mar sheets checking etc. Just pure economics.
johnep

[Pharmanaut]

The reason for obtaining weekly scripts is the cost of preparing dosettes. Just time yourself. One minute for 28 days in one box, 28 minutes for 4 dosette boxes with Mar sheets checking etc. Just pure economics.
johnep

Yes - the fee is for adjustments under the DDA.
Expected not to be for everyone!

Another reason for shorter term scripts - is a change of medication.
Also some tablet formulations are a risk if packed in anything other than 7 day cassettes.
(Leave a clopidogrel tablet out of packaging, also Nicorandil (yes we dosette those but only in 7 day packs - due to homecare rules)
The amount in the contract doesn't cover repacking existing dosettes.
Will the GP provide prescriptions to cover a repack of all the items, as they all have to be checked again?

So the choice is do the 4x7 cassettes or lose the script to a multiple?

Often ask myself - does everyone need a dosette box?
Or do some people just need a visit to "weed out" their medication cupboard/drawer and continue with normal packaging and a MAR chart?

Round here though, homecare won't touch medication unless it is dosette.
Either that or the patient goes from own home to a care home or hospital at a vast cost to NHS.
So weekly prescriptions in dosette are a cheap option.
Does that help with your discussions with the practice manager?

Might have posted all this before - if I have ignore me droning on.

[crit care]

i think dosettes are the biggest waste of time..doesn't necessairily help ALL patients....they can still forget to take them! i think to do 4x7 dosettes may be easier and better on the time management than doing weekly dosettes, and havin to chase GP for scripts

[Pharmanaut]

i think dosettes are the biggest waste of time..doesn't necessairily help ALL patients....they can still forget to take them! i think to do 4x7 dosettes may be easier and better on the time management than doing weekly dosettes, and havin to chase GP for scripts

Scripts organised - Collect 4 weeks at once.
Easy to change medication - GP issues single script(s) for replacement weeks and we delete replaced medication on outstanding scripts
Runs reasonably smoothly - each patient has collection/delivery day and we do tomorrows today. Around 10 per day.
Usual hiccups around Bank Holidays/Xmas but easy to plan for as they are known events!!!
System explained carefully to each patient. Patient/Carer told to call us asap if GP changes meds. (one patient rang on way home in ambulance!)
Works smoothly most of the time.

[Defblade]

You could point out to GPs that the DDA (which requires reasonable changes to businesses in order to accommodate the disabled.... and a medical practice is a business) applies to them too - not our problem if thier neogiators (sp?) failed to secure them extra money to help comply with it.

In the meantime, pointing out that in the event of a single tablet change you will need scripts for a full set of new boxes usually sorts things out.

And despite PCTs/LHBs saying otherwise, the Repeat Dispensing scheme works perfectly with stable MDS patients - usually providing 3 months of weekly Rxs for one signature at the surgery end.


Why PCTs, LHBs and GPs all get worked up about it anyway I'm not sure - the cost of the drugs will be indentical (assuming no changes, in which case 28 days is worse) and the dispensing fees come out of the Gobal Sum, which doesn't chnage anyway (if too much is paid out, payments are reduced in future to compensate). We're only taking money off other pharmacists in the end.


My boss (independent) has decided it's simply not worth keeping patients if an MDS is "required" and the GP won't do weekly scripts; happily there's a competitor (large multiple) down the road the who are only interested in script numbers regardless of cost We've explained cearly and simply why we won't and, funnily enough, the GPs keep backing down and doing 7 days

[johnep]

Often have been asked to have units back and take a tablet out and put in another. They do not seem to understand that completely against best practice. Multiple where I worked would simply get a script to cover the one tablet change.
That branch simply used MDS as a means of increasing staff hours allowed.
johnep

[Racer]

.


My boss (independent) has decided it's simply not worth keeping patients if an MDS is "required" and the GP won't do weekly scripts; happily there's a competitor (large multiple) down the road the who are only interested in script numbers regardless of cost We've explained cearly and simply why we won't and, funnily enough, the GPs keep backing down and doing 7 days

I've always taken a hard line with this. We'll do MDS only for 7 day scripts because of the labour intensive nature of making the packs. If the multiples want to do it for 28 days then they can have it!