Pharmacy at the the surgery causing problems

[razorbladekisses]

At the start of the year our local surgery opened a pharmacy (portacabin). As a result our Rx numbers have declined from approximately 7000-4500 items a month. Many patients that used to be on our prescription collection service have changed and their prescriptions now go to the new pharmacy at the surgery. We have no problem with patients changing of their own accord but we do have a problem with the surgery directing patients to their own pharmacy and automatically changing prescription destinations to their own pharmacy. Many patients are coming into our pharmacy to collect their prescriptions only for us to discover that they have been given to the surgery pharmacy instead. These patients have signed up to our service yet this seems to be ignored by the surgery. Am I right in thinking this is not allowed?

Recently an MDS patient of ours suddenly changed to the new pharmacy. We were interested to find out her reasons for changing as perhaps it was to do with our service but no, she said everything was fine just that it was easier for the Doctor if her Rx's went to the surgery pharmacy. Another patient (managed repeat) her Rx failed to come back in 3 days we had to request it and when it came back to us it's destination had been changed from 'our pharmacy' to 'surgery'

Someone at the surgery or possibly the pharmacy itself (pharmacist used to work for the company I'm working for) are manually changing prescription destinations without patient consent and/or deliberately witholding Rx's.

It really is frustrating that this is happening and I don't really know what to do about it. Any suggestions?

[johnep]

I am afraid this is the result of allowing prescribers to own pharmacies. As all the DDs open 100 hour pharmacies the direction of scripts to the surgery owned pharmacy will gradually reduce the viability of pharmacies locally. Eventually the govnmt will attain what they want. One stop health centres.

In the meantime, gather evidence (photocopy directed scripts) and then protest to PCT. Unfortunately Drs hold the reins at the PCT and any complaint will probably back fire on you. The DM may be a better avenue re 'Drs lining their own pockets.'
johnep

[Tony Schofield]

There are strict rules about direction of prescriptions and they have been broken here. Complain to the medicines management lead and demand that anyone involved in investigating the situation declare any interest they have.

It is quite wrong to believe that the PCT will side with a practice and if they do as a result of said doctor having a loud voice there, the PCT directors are incredibly vulnerable.

If you make enough noise there is not a chance in hell of the PCT ignoring you. Attitudes like those of Johnep, that it may backfire, are the reason that pharmacy sems to get a raw deal:- if you don't complain who else will?

Also, any evidence of any "backfiring" must be presented to a higher authority. PCTs are the stewards of public money and are accordingly accountable. Believe me they take that responsibility seriously.

[jaymags]

This happened to us a few years ago but specifically with only a couple of surgeries. Our customers were told they couldn't have their tray medication from us because they only dealt with "the pharmacy next door". We pointed out to the patient the choice was entirely theirs and that they should tell the surgery where they wanted thier prescription to go to, we even provide return envelopes for the surgeries that are too far away for us to reasonably get to.
We also complained to the the practice managers which solved the problem. Always try at the source first then go higher if need be.

[Jeff]

There are strict rules about direction of prescriptions and they have been broken here.

Are there? Last time I checked (several years ago - so I'm happy to be corrected) there wasn't anything in a GP's Terms of Service about directing scripts?

Jeff

[emelianenko]

Get a letter from the patients as proof that the scripts have been re-directed without their consent and report it.

We had an incident where an inspector visited our pharmacy recently that customers have complained that we are receiving their scripts from the doctors without the patients consent and that its not taken lightly. Luckily for us we had all PCS forms signed etc and it was just a pharmacist next to the surgery who couldnt take it that he was losing customers and resorted to writing the letters himself and getting patients who couldnt read, write or speak english to sign it. So if an inspector was sent down to reprimand us at our place over just 2 letters? Im sure you could get genuine support from your patients and report this.

[pharmatron]

The GMC is quite clear in its view on doctors and pharmacies:
(GMC | Good Practice in Prescribing Medicines)

"Doctors' interests in pharmacies
You should ensure that your patients have access to information about your own and (where known) your employers' financial or commercial interests in any pharmacy they are likely to use.


Patients should be free to choose from which pharmacy to have their prescribed medicines dispensed. Advice about specialist pharmacies or those that offer collection and delivery services, for example, can be helpful. It might not be practical or clinically appropriate for patients to use alternative pharmacies when in hospital or visiting clinics at which medicines are dispensed free of charge.


You must not allow your own or your employers' financial or commercial interests in a pharmacy to influence the way you advise patients. You should not accept any inducement which may affect or be seen to affect the advice you give patients. You must not pressurise patients to use a particular pharmacy in any event, either personally or through an agent, nor should you disparage or otherwise undermine patients' trust in a pharmacy or pharmacist by making malicious or unfounded criticisms."

[Pharmanaut]

Interesting times lie ahead in EPSR2 when nominated pharmacies are possible.