3Likescommunity pharmacy in 5 years ??
will it have changed much from now?
(the new pharmacy contract -is it in place yet?)
King Amongst Members
community pharmacy in 5 years ??
will it have changed much from now?
(the new pharmacy contract -is it in place yet?)
Moderator
The way things are going, may not be any need for pharmacists in community.
ACTs will replace as cheap labour with one pharmacist remotely supervising many pharmacies.
johnep
King Amongst Members
I'm not convinced about remote supervision. It requires the decision to contact the pharmacist to be taken by the ACT and in doing so passes a clinical decision for which the ACT is not trained (authorised?).
The satelite dispensing model is more likely to be prevalent in 5 years. EPS allowing scripts to be sent to a central dispensing warehouse with completed scripts delivered either direct to the patient or via a network of local pharmacies.
This model gives community pharmacists the time they need for the extra service provision that has been promised. The local pharmacy becomes the first point of contact rather than the doctor, dealing directly with minor ailments and managing long term medication.
Loyal Member
Originally Posted by johnep
Once EPS allows patients to nominate their preferred pharmacy to receive their prescriptions, then the starting flag is raised for altering the existing pattern of where prescriptions are dispensed. EPS will ensure that repeat prescriptions will arrive at their designated pharmacy well in advance of the patient and allow dispensing in readiness for collection.
The next step is when EPS is used to transmit non-urgent repeat prescriptions to the prescription processing centre of a large company, where the company distributes the completed items to their branches overnight. The patient would not notice any difference. This concept of “hub and spoke” dispensing will increase efficiency and so reduce costs. Robotic dispensers linked to existing pharmacy systems software exist now and work with frightening efficiency around the clock.
The Responsible Pharmacist legislation will allow pharmacy owners to delegate the running of their business to a nominated pharmacist. The Department of Health has said that currently pharmacy technicians will be excluded from taking charge although this is likely to be reviewed in the future. This statement should be enough to make all community pharmacists sit bolt upright
If dispensing technicians are eventually allowed to take charge of the pharmacy that receives these completed prescriptions, the next dilution of supervision will be video links in the pharmacy to a central pharmacist help desk to allow face-to-face discussions with patients who have specific problems.
The video link pharmacist will have access to the patient’s medication record, the prescription that has been dispensed and any other viewable information held on the NHS spine. One responsible pharmacist for each pharmacy will disappear.
The outcome would be to reduce pharmacy running costs and relieve the problem of obtaining locum cover. Dispensing fees can be further reduced due to the more efficient dispensing techniques, and the larger pharmacy companies, which are in a position to afford such an investment, will gain from the changes due to the economy of scale.
What I have outlined so far seems to favour the larger pharmacy chains and they are probably happy with the impending legislation. However, I do not believe they will be safe in the long term either.
Data captured by EPS already collates what has been prescribed and what is eventually dispensed. With such detailed information, what is to stop the Government eventually putting out to tender for the best price of what is dispensed nationally and using the dictionary of medicines and devices held within EPS to force contractors into using a specific dispensed product?
This is the exact same mechanism that many large companies already enforce on their employee pharmacists using existing dispensing software control. Why would the Government not employ exactly the same control by using EPS to restrict all contractors’ choice of dispensed product down to a single specific generic manufacturer? It could easily be made technically possible.
The first step in removing the pharmacist from the dispensary is the responsible pharmacist legislation. Not suprisingly, supported by the large pharmacy chains. As I have said before, pharmacists need to think carefully about the long-term implications involved before being allowed to “temporarily vacate the premises” abandon patient contact and offer services to those who may well have no money, interest or inclination to pay for them.
Graham Morris
Moderator
Completely agree, of course what will happen is that DUH will force down price until only one supplier. That supplier probably abroad. Then will come the inevitable fire, strike, revolution etc and all will fall apart.
johnep
King Amongst Members
so ...basically community pharmacy will get worse?
what new services will there be av and new policies if any that affect the patient?
Newly registered in 1981
...and there's nothing to stop the remote pharmacist being in an overseas centre?
...and don't forget there are robots that can pack MDS as well.
All this is very scary to us vocational pharmacists.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
King Amongst Members
Here we go again. All doom and gloom, armageddon. Then again i wont be a vocational pharmacist so cant be bothered to concernmyself with all this misery. All it serves to do its demoralise people and effect their motivation.
Newly registered in 1981
Go on then, what will you be?
And you have a valid point that we are all doom and gloom.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
Loyal Member
It is quite easy to suggest that what I’m describing is all doom and gloom. However, there is not one point in my post that is not technically possible.
It is my belief that the profession are being lured out of the dispensary to weaken their position within the dispensing process and to reduce their face to face contact with the very patients that support their business.
I have spent many a busy year dealing face-to-face with customers, discussing problems with doctors, district nurses, practice nurses, local hospices, care homes, supervising methadone, etc. all within the confines of the dispensary. That is, of course, between updating my continuing professional development and standard operating procedures, performing medicines use reviews and dealing with the ever increasing paper workload that seems to have mushroomed out of all proportion.
What a fool I have been. I can only assume that all my efforts were in vain as I should have just trained up one of my staff to perform my role. Each morning I could have read the paper in the stockroom, with my feet up for two hours and let the dispensary look after itself. If there are any problems that cannot be solved the staff can tell the patient to come back later.
Do you honestly believe technicians will fulfil this role to your professional satisfaction? For years we have promoted the knowledge, convenience and accessibility of pharmacists; now it is beginning to appear as if it was all for nothing. Do you think a patient will return two hours later to discuss a problem when a pharmacy down the street has a pharmacist on duty?
Patients have had a rough deal from governmental contract changes to the health professions. What a great success the new GP contract has proven to be; now the majority of patients are unable to contact their GPs over a weekend. However, patients can at least keep themselves busy by extracting their own teeth with a pair of pliers while sitting in casualty in the hope of seeing a doctor to solve their dental problems.
The result of these changes is the worse accessibility to GPs and dentists that I have seen in my 30-year career. The most polite way of describing the situation is as a shambles. Now the latest brainwave of “responsible pharmacist” will reduce patient access to their pharmacists in their pharmacies, while weakening your long-term future and income.
Already a large number of independents do not fulfil their MUR quota because they realise that it is impossible to safely run the dispensary whilst hurriedly performing a MUR. I feel sorry for those pharmacists being bullied by area managers to fulfil their MUR quotas in dispensary environments that are often understaffed. A recent pole in the C&D also quotes than nine out of ten pharmacists will not use the responsible pharmacist absence option. Without doubt, you need a second pharmacist to abandon the dispensary in these ways.
Remote dispensing and checking would appear to solve this problem. Scripts remotely dispensed and delivered to the pharmacy ready checked could be handed out to the patient with counselling points fed to the technician via a VDU. Remote supervision will cater for any questions not answered by the dispensing staff. It will release the pharmacist from the physical process of maintaining the safety of the in house dispensed item. In such circumstances it would be easier and safer to perform MURs and vacate the dispensary to perform the myriad of tasks we are told can be performed.
However, be careful, very careful. If brains were gunpowder, many politicians would not present as a fire hazard. The same cannot be said of the forces at play that are slowly manoeuvring community pharmacists into a vulnerable position.
There is not one element of my first post that could not be implemented by a government wishing to reduce costs in the NHS. Expensive contractors to the NHS are a fair target. You may consider my posts as “doom and gloom”, but I am only placing the pieces of the jig saw in front of you.
No doubt others will show you how they fit into a much rosier picture of the future. However, until I can be convinced of this, I still feel that the profession are being slowly but surely manoeuvred into a very perilous position.
Posting Permissions
Reply With Quote