Essentials of Endorsing

[Pharmanaut]

The blacklist is in dire need of an update. It is extremely out-of-date and there are many nonsensical inconsistencies. Also, many products were discontinued a long time ago and ought to have been removed.

As the products have to be listed there exactly by name then a slight tweak of the name means that it is no longer blacklisted. That is until the blacklist catches up and it is not updated that much.

Some kind of "Part IX" for drugs might be the answer - easier to check if it is allowed rather than to check if its not allowed.

The otrivine example makes you look like a traffic warden type jobsworth.

[bobbin]

As the products have to be listed there exactly by name then a slight tweak of the name means that it is no longer blacklisted. That is until the blacklist catches up and it is not updated that much.

Yes precisely, and many OTC products have their names amended regularly... max changes to plus then to extra then to ultra. A group of workers need to have a good hard look at the blacklist. There are so many glaring inconsistencies. Some branded products are blacklisted and yet the DT price for the generic version is Cat C based the price of the blacklisted brand. How ridiculous.

I think we need new arrangements for food items, particularly gluten-free. At present, *all* non-ACBS foods are allowed on prescription unless they are blacklisted, which few are. It would be much more sensible if *only* the food items on the ACBS list were permitted.

[tinx25388]

I think we need new arrangements for food items, particularly gluten-free. At present, *all* non-ACBS foods are allowed on prescription unless they are blacklisted, which few are. It would be much more sensible if *only* the food items on the ACBS list were permitted.

Our PCT has decided that we are only to dispense bread or flour for any scripts from within the PCT, no more biscuits and bits!

[bobbin]

Our PCT has decided that we are only to dispense bread or flour for any scripts from within the PCT, no more biscuits and bits!

Quite a few PCTs are advising doctors to restrict prescribing of GF items. Two issues:

1. Doctors can ignore the guidelines, because they are just that: guidelines.

2. No one should be getting biscuits on prescription. The NHS does not exist to provide free biscuits - it is an entirely unreasonable use of limited NHS resources (and taxpayers money).

The thing is, there should not be a 'postcode lottery' for food prescribing, or any prescribing for that matter. The same rules should apply throughout the NHS. Apart from things which differ locally eg. antibiotic resistance patterns and hence selection of antimicrobials, there is no need for each PCT to have their own rules and guidelines for everything. This type of inefficient duplication of work is one of the reasons that our NHS is so wasteful. No wonder other countries spend less and achieve more! Simple national rules and guidelines are all that is needed for most things.

[ltlbkofjim]

Our PCT has decided that we are only to dispense bread or flour for any scripts from within the PCT, no more biscuits and bits!

The PCT has decided that you can't 'dispense' these other items??
Surely this leads to some difficult situations, I realise the pharmacy contract is with the PCT but refusing to dispense a prescribed item that is not blacklisted and there is no clinical reason to not dispense would surely be in breach of your contract? I can understand PCT issuing guidelines to GPs to restrict the prescribing (as prev mentioned), but surely informing pharmacies to refuse to dispense these other items on legal prescriptions is a whole different matter.
Please someone correct me if I am wrong here, but if I was put in this position I would find it very difficult to defend myself if I was accused of refusing to dispense a legal prescription.

[johnep]

No we have to dispense if legal. however as often just repeated by receptionist, it might be wise to confirm with surgery, as long as you dot have stock that would just go out of date.
johnep

[Pharmanaut]

No we have to dispense if legal. however as often just repeated by receptionist, it might be wise to confirm with surgery, as long as you dot have stock that would just go out of date.
johnep

Would always check if the patient is in the "repeat prescription trap"; ie receptionist is too busy to hits "repeat all". (See below)
Otherwise, our contract is to "Dispense with reasonable promptness" - which is what we do.

Busy Receptionist....
Two Comments recently.
1. "You are always ringing - you pharmacists will do anything for a prescription". (mentioned before - but there's more...)
2. Receptionist now a trained phlebotomists so hates being interrupted when running her clinics. (see 2)
3. Instructions from 3 are now not to call but to send the patient back but only when clinic is over and samples have gone off. Patients returning beforehand will have to wait their turn.

[Asterix]

what happens if a rx contains 3 items but pt doesn't want one so you only dispense 2 and don't endorse. How can you be sure ppd doesn't pay for all 3?

[johnep]

Supposed to strike out item . We we also put 'not dispensed'.
johnep

[Pharmanaut]

Supposed to strike out item . We we also put 'not dispensed'.
johnep

We usually write ND next to them and only strike out when filing.

Mainly because once it has been crossed off you can't uncross them out and patients do get confused with which is which.

A while ago we had a patient with a 4 item script - he crossed out the wrong item himself and got really hot under the collar when told that we were unable to dispense it.