Pharmacy support staff and the future

[Jeff]

Originally Posted by admin

I know that Jeff, but I still go places where people have had repeated diclofenac 75mg 1 tds all the time. Who is clinically checking these scripts? The Dr isn't, and the pharmacist doesn't appear to be doing it either.

Wether it's a repeat or not, I still try to look at each script with a clinical view. I say try, because if you are doing over I'd say 400-500 items a day it's very hard to do. When you get up over the 600 mark I personally find it just about impossible.

I'd agree with all of that. So rethink the process. Tag a script as clinically checked along with the pharmacist responsible for the check. Then as long as it's repeated the pharmacist in charge need not carry out a clinical check. Then out of your 600 items a day a clinical check will only be needed on a hundred or so. This should all be possible in software.

Jeff

[admin]

Originally Posted by Jeff

I'd agree with all of that. So rethink the process. Tag a script as clinically checked along with the pharmacist responsible for the check. Then as long as it's repeated the pharmacist in charge need not carry out a clinical check. Then out of your 600 items a day a clinical check will only be needed on a hundred or so. This should all be possible in software.

Jeff

It is possible with most software to add a note about the individual, but a lot of them have to have their details looked at, so there is no note on the screen you see. This would at least double the labelling time for each person, unless you remembered the individual.

Remember though that I work as a locum, so cannot tell people how to run their pharmacies. I often add a note to a persons details regarding an intervention I have made etc but haven't seen many other people doing this.

If I was in the same place all the time, then yes I would do that. In reality though other pharmacists don't do it. I might try suggesting some start, but as I say you would need to go into their records to find the notes made.

It'a a good idea for a busy dispensary and I do like the idea. I'm just not sure who else would be prepared to do it as well.

To be honest Jeff, a lot of the locums I follow are terrible, and I wouldn't give them work if it was up to me. My friend with the 150 addicts has problems with locums all the time. Here's a couple of examples of the standard of service some of them offer: -

My friend with over 150 addicts was on holiday for a long weekend Friday to Tuesday. When he came back, the locum for Friday did not fill in over half of the entries for methadone collection on that day. When asked why, he had no answer. The staff said he was not busy with any scripts, and just had the methadone patients to look after. My friend had to go through the CCTV tapes, as he said "they all turned up". My friend felt he could not rely on anything this guy said, so needed to see for himself if they had attended that day. The locum did not seem to know that this was a legal requirement on his part.

The same guy was booked for Saturday. He just didn't turn up, and when phoned just said he didn't like it. He did not however let the company or the agency know, so the staff had diamorphine addicts actually crying outside until 11.30am when another pharmacist turned up.

The guy for Monday banned three people from the store. My friend said they had never given him any trouble, and were at their "last chance" with the surgery that prescribes for them. He said if they lost their methadone, they would just start stealing again, and buy street drugs. They had however been clean for over six months, and seemed to be trying to kick their addiction. When he asked what they had done, he told me the guy could not speak English, so he couldn't understand what the problem was. He let them back in to use the pharmacy, and they are still there, and still cause no problems.

So a long weekend gave my friend a nightmare return, with all the problems (and more I have not mentioned) to sort out.

Another pharmacy I regularly do a saturday morning in had a guy ring on the Friday before he was due to come. He asked the lad who answered the phone if the shop was busy. This lad is also works on the Saturday morning, and told him it could get quite busy. Again, the guy just never turned up. That left the staff with six very angry addicts that wanted their methadone for the weekend. They managed to get someone by 12, and they shut at 12.30. When contacted, he said he didn't fancy doing much work on a Saturday morning, and again did not let anyone know he wasn't going to attend. He was not ill.

I follow these kind of pharmacists all the time. They would not even know how to do a clinical check, never mind put it on a computer.

I know all three pharmacists that caused these problems, and they are by no way the worst I have followed.

[Jeff]

I follow these kind of pharmacists all the time. They would not even know how to do a clinical check, never mind put it on a computer.

This is an argument designed to convince me that we need pharmacists? Sounds very much like pharmacies wiould run more efficiently without.

Jeff

[admin]

Originally Posted by Jeff

This is an argument designed to convince me that we need pharmacists? Sounds very much like pharmacies wiould run more efficiently without.

Jeff

No it's just to let you know what kind of people are out there, and how hard it is to get some of them to just work for the day.

It's also to give you an idea of what you could be following when you are doing your locums.

[Jeff]

I've only spent 5 months as an employee (though most locums were long term)
It's the first of the month when previous locums have done SFA in preparation that bugs me ;-)

Jeff

[kemzero]

Some aspects of repeat dispensing cannot be delegated ..check the criteria outlined in the service spec. as far as I am concerned you can delegate anything as long as you are willing to carry the can if anything happens ..if staff are competent and you have the right SOPs then why not...but Patient safety must never be compromised for whatever reason