Does Pharmacy need dispensing?

[ronz22]

This may seem like a weird question but in a class meeting this topic was discussed and is interesting. My initial thoughts were obviously pharmacy does need dispensing but others said that pharmacists should move on to focusing more on enhanced and advanced services which includes things like EHC service, substance misuse service and MURs. Should pharmacists move on and let trained staff take care of the dispensing side? Or should dispensing be scrapped from pharmacies completely and done in a location which only dispenses?

I would like to know other peoples thought on this topic. Also i wonder if anyone knows how much a pharmacy makes on average per year on dispensing alone? Because if dispensing were to be replaced....how are pharmacies going to make that money through something else?

[johnep]

Well, no one wants to pay us for enhanced services. When they do we will consider.
johnep

[ronz22]

Thanks for replying! What about if we ignore the money aspect for now and think of 'the role of a pharmacist'. What do you think from that point of view?

[Pharmanaut]

Thanks for replying! What about if we ignore the money aspect for now and think of 'the role of a pharmacist'. What do you think from that point of view?

My thoughts are that the pharmacist is needed in dispensing more than ever.
For sole purpose of patient safety.
Why - because of the false sense of security computerisation will introduce into the the prescription service.
You can only trust computers when you know the information is correct.
How do you check that it is correct without someone who knows what they are doing?

Problem is how do you gather evidence that you have made the process safer.

[ronz22]

Yea i totally agree that pharmacists clinical knowledge is required for patient safety. Going back to the title of the thread 'Does pharmacy need dispensing'....one person in our meeting said that there should be a different place where you go and get the drugs, which is still dispensed by pharmacists but just not in a pharmacy. This would allow pharmacists in the pharmacy to carry out with advanced and enhanced services. I personally dont agree but what do you think about this?

[LeftArm]

This kind of thinking is already having an effect. Groups and multiples are all thinking about hub and spoke dispensing. The effects of EPS may make large numbers of repeat scripts go to internet pharmacy. The move is towards bulk prescription factories doing thoussands of items daily probably overseen by one or two pharmacists but with volumes per pharmacist hour much greater than now. This can then be supplied to patients by delivery services or picked up from a pharmacy. (or a machine?)

Clinical knowledge is required for patient safety but actually is only needed in a minority of cases. Is it cost or time effective to manually check 1000 prescriptions to find 5 that require reference to the doctor? 800 of those items are likely to be repeated month on month without ever being properly checked for effectiveness. These can easily be done by an ACT with a computer without any effect on patient safety.

Going back to those 800 items that don't require intervention at the dispensing stage. If the pharmacist actually talks to these 200 patients (4 items each?) they will be able to recommend a more effective drug regime and find ways to improve patient outcomes (I hate jargon but you know what I mean). This is a far better use of 5 years training than checking the quantity of tablets in a box.

The outcome is that if a pharmacy relies on dispensing alone then they will soon be dead in the water. To quote Xrayser's Christmas message

“What are the pharmacists doing?”
“You’re squabbling over the last few scripts on the high street,” the ghost said.

[bobbin]

Should pharmacists move on......

....on to the dole?

Quite frankly, the point at which the powers that be decide that pharmacy does not need dispensing will mark the end of most community pharmacists' careers.

Most PCTs have not been keen to fund new services to any great extent. Some of these services are more appropriate for Health care Assistants at the local surgery, others are simply unrelated to pharmacists' knowledge of medication. The fact that these services are not properly integrated with primary medical services also makes them problematic in some cases.

Of course, there ARE roles for community pharmacists outside the dispensary, but how many such roles exist? Not enough, I can assure you.

[culchie82]

I agree with Bobbin, you take away the bread and butter dispensing in Community Pharmacy, then what are you left with? Does anybody seriously think the Multiples will continue to employ Pharmacists purely for "enhanced services", when the Governement are cutting left, right and centre?

[Pharmanaut]

I agree with Bobbin, you take away the bread and butter dispensing in Community Pharmacy, then what are you left with? Does anybody seriously think the Multiples will continue to employ Pharmacists purely for "enhanced services", when the Governement are cutting left, right and centre?

Then the cost of service enquiry will reduce or remove the proportion for pharmacist input and lo, the margin will be cut again. Which is great for high volume low overhead dispensing.

Hub and spoke depends on an efficient transport network. Argument in one word here - Snow!

If you have a 1000 scripts and 800 are correct and 200 might have an error, how do you find the 200 without looking all 1000 against the PMR?

Enough for now - giving me Forum induced cephalgia.

[culchie82]

It's ironic, that the thing that most Pharmacists complain about (ie incessant checking of scripts), is the thing that is keeping us all in a job! IMHO, this greater clinical role is all BS, it won't happen.

Community is industrialised as it is, but not near industrialised enough for the multiples!