Emergency supply

[Fleegle]

Are British pharmacists "brave enough" to confidently supply medicines to people in genuine need on an emergency supply basis, or are they running scared of the legal department of the RPSGB..the "governing body"?

There appears to be such a stigma amongst pharmacists regarding supply of medicines without prescription in emergency situations...eg. Pallative care patient needs morphine NOW..no script..NO..more than my job's worth..

Without creating a purely legal debate, can I ask you to post your thoughts from both the legal and ethical viewpoints; do we live in fear of being removed from the register for merely carrying out our duty as professionals?

[lamzee]

At the risk of sticking my head above the parapet, I get the impression that younger members are less likely to supply because they don't want to ruin their career/have lots of student or mortgage debt and can't afford to be struck off. I think those over 50 have less to lose, and are more likely to supply.

[johnep]

Unfortunately the law does not put the patient first. If you make an ES of morphine likely to end up with a police caution and no trips to USA.
johnep

[Sir_Dispensalot]

Originally Posted by johnep

Unfortunately the law does not put the patient first. If you make an ES of morphine likely to end up with a police caution and no trips to USA.
johnep

not to mention getting hauled up in front of statcom and reprimanded or struck off...

[admin]

Originally Posted by lamzee

At the risk of sticking my head above the parapet, I get the impression that younger members are less likely to supply because they don't want to ruin their career/have lots of student or mortgage debt and can't afford to be struck off. I think those over 50 have less to lose, and are more likely to supply.

Too right - exactly right in fact! You are simply stating the truth.

[ymdawd]

It is simply illegal to supply morphine in these circumstances. Would not blame any pharmacist who refused to supply.

Have to confess I once did supply diamorphine 100mg amps to a terminal cancer patient who had been left" high and dry" by the system over the weekend. This happened several years ago but it still makes me so angry. Was glad when the Rx turned up on Monday morning though. Nobody was any the wiser. Guess I was just lucky.

Normally I would never do that but I did do a LOT of phoning around to GP's etc to make sure re circumstances of case before I decided to take a chance.

Yes it was technically illegal but I would maintain in any court of law or in front of the statutory commmitee that my carefully considered course of action was the correct one in the circumstances.

[johnep]

The officials would still chant 'Off with his head'.
johnep

[Steve G]

I wouldn't supply a CD without an Rx, apart from in some very specific circumstances (i.e. a phone call from a GP who works next door on a Sunday for a terminally ill patient, but they've been called while they were out and haven't got any FP10's with them).

I have supplied CDs against prescriptions that are not strictly legal, for example diamorphine 10mg amps mdu in syringe driver, zomorph 10mg bd, after weighing up the situation and being happy to defend my actions if need be.

[Fleegle]

This is obviously a sensitive subject with all of us. It's quite simply professional ethics vs the law of the land, with the pharmacist well and truly stuck in the middle. We all know the law, but my heart would not allow me to refuse (e.g.) morphine to a person who, regularly, has only hours left with us. Why is "by syringe driver mdu" not sufficient as a dose?..it bloody well should be..the nurses in these cases know exactly what they're doing and of course the dose will change...the patient is hardly abusing this medication..and has a right to dignity in their last hours.

I fully agree that older pharmacists will have more sympathy/empathy in these difficult cases. Personally I find that the older you are, the more respect you get from the GP.

I left the UK in 1997, and retained my RPSGB membership until a couple of years ago, when the whole "resign or else" debacle reared its ugly head. I resigned.

I have been in Ireland since '97 still practicing. Even as a locum I am on first name terms with every GP..they have no pretensions. We work together for the good of the patient, and CD supply issues are dealt with quickly and efficiently.

I have total confidence in the system here.

No Irish pharmacist has ever been struck off.

[lamzee]

Originally Posted by Fleegle

I have been in Ireland since '97 still practicing. Even as a locum I am on first name terms with every GP..they have no pretensions. We work together for the good of the patient, and CD supply issues are dealt with quickly and efficiently.

I have total confidence in the system here.

No Irish pharmacist has ever been struck off.

Is this because the GPs in Ireland are competing for a market share of patients, whereas GPs in the UK have a fairly captive market?
(just a question--I have worked under Irish and UK systems)