urgently need advice - CD, lost script....

[johnep]

OK, thank goodness all seems good. If script is green and has instalments on it, use fax machine to copy. anonymise , and lets have a look or refer for comment by PCT CD lead.
This needs a firm decision from someone.
Now you can sleep tonight.
johnep

[Pharmanaut]

ok but I've checked with couple of other people, In scotland you can give 28 days supply on a normal Rx (GP10(A)), so this probably was legal. also with regards to the labels being instalments, and I am guessing the script was for 56, and the Dr put "weekly dispense" on it, so someone just created 4 instalment labels. But still leaves the problem of no script! The surgery will be open soon, gives me some time to phone up and try and sort it out before I have to go to the pharmacy at 9. Contemplating just going to the surgery in person, but that might annoy them.

Pedant Alert.
GP10A is the stock order form.
Assume you meant GP10
Rest of post is good.
End of alert.

My regular readers might find this useful, though I'm not sure why it says "not paid for dispensing".
Valid Prescription Forms · Funding & Drug Tariff · PSNC

[johnep]

What we need to know is can a Dr put 'dispense daily/weekly' on a green form and will the pharmacy be paid a fee for each supply?
Drs do nothing for nothing, but expect pharmacies to do all for nowt. Next thing will be a green script for a year with 'dispense monthly/weekly/daily' on it for just the one dispensing fee. We must have 'cheap mug' written on our foreheads.
johnep

[pharmer7]

You guys are not going to believe this. Sorting through a bunch of old scripts I found somewhere underneath loads of balances, I found that old script for MST lying in there... Someone must have been writing in CD entries or something, and left some scripts in one of those green boxes that a certain multiple uses. When the pharmacy is absolutely covered in those boxes, hard to know where a single script would be, especially when your under pressure and up to your neck in problems, and when the rest of the scripts for the dosette box are together. That will now be sent back to the surgery as it hasn't been touched, and can resume as "normal", whatever that is... At least the patient got his MST.
However, the dispenser has just brought to my attention yet another set of scripts for a different patient which are without MST. We're hoping it is coming in the morning, but if that doesn't come, then its the same old story over again. That script has also been hunted for, and also looking in that same old pile of scripts but no luck. The surgery had printed it two days ago, but guessing since its a CD there was a delay with it and it was left to the next day and then had to be signed. I seriously cannot cope with any more problems like this, and if that script is not sorted tomorrow, I don't know what to do. I understand I'm the pharmacist, but I am not qualified in hunting down scripts and being psychic, surely the dispensers and other staff need to take some responsibility? If anything is not a simple case of label and dispense then it gets thrown at me and I get hit with "what do you want to do?", "You're the pharmacist...". Adding to that, there was yet another problem with a CD, script for oxycodone 5mg was given from the surgery and duplicated instead of also giving one for 10mg. So spent most of my day sorting that one out as well....

@ roper - I thought other places I went were nightmares, but this pretty much tops them. Maybe just because I have to stay somewhere for a few days, but because every possible problem you could even think of seems to be occuring in this place. There's so many problems I found in this place I could write a book. If they wanted me to book again I would probably want at least £50 an hour, and even then I would be reluctant.

[johnep]

The computer message which says a script has been printed, not always correct. It means that the script has been sent to the printer, not that it has physically been printed. In the meantime the printer could be switched off, and the script could be in limbo.

CD scripts put in special places has been a nightmare to me in the past.
johnep

[bobbin]

What we need to know is can a Dr put 'dispense daily/weekly' on a green form and will the pharmacy be paid a fee for each supply?
Drs do nothing for nothing, but expect pharmacies to do all for nowt. Next thing will be a green script for a year with 'dispense monthly/weekly/daily' on it for just the one dispensing fee. We must have 'cheap mug' written on our foreheads.
johnep

Yep, if the script is green, you should not dispense in installments... and if you do, you will certainly not receive any additional fees regardless of what the doctor has written.

[pharmer7]

Can't believe I made it through this week without topping myself. Yet another last minute cd drug rush, patient didn't get his morphine tabs in from surgery, even though it was ordered. Got sorted out by getting a driver from somewhere else to come and get it. And just by the by, what the hell is clinical governance? Someone told me to "be aware" of this and sops. Any trusted member can ask me more details, don't want to talk too much in the open about this.

[Nik]

And just by the by, what the hell is clinical governance?

Essentially the vehicle for continuing to try and improve the quality of patient care we provide whilst also aiming to improve our own standards. A load of NHS related jargon in other words.

[hibernia]

And just by the by, what the hell is clinical governance? Someone told me to "be aware" of this and sops.

Governance, of any kind, involves covering a certain part of your anatomy, and making sure someone else, anyone else, gets the blame when things so wrong.

I'm willing to bet that there are a set of SOPs in that shop and if I read them (and I might be the first person ever to read them) I would conclude that it is the most perfectly run pharmacy on the planet.

What is written down becomes the reality so engage in a bit of governance yourself and write down in detail everything you can remember. You never know when it might come in useful.

[kl06229]

oh the wonders of working as a locum... Chaotic first day, no regular staff, all off sick, bereavements,etc. A CD script for a dosette box (yes MST goes into box), looks to have gone missing. Cannot find anywhere, and there is a remote possibility it was just filed. In which case it has now been sent off to the pricing bureau... Reason I'm up so late is I'm dreading going back into that store and dealing with more problems, just cannot get to sleep. Will try nicely asking surgery to reprint, but got a feeling they would not do it, because its basically due to the stupidity of someone at the pharmacy. Box will be due to go out soon, but should have that MST inside. What can be done in this situation?

Secondly, another irate woman saying her mother "needs assessed for a dosette box"?? I have never done this before, don't even know where to start and neither do the other staff. It was left to a couple of members of the regular staff, who don't look like they're returning any time soon. Would the surgery even authorise me to do something like this, as I have undergone no training and they don't know me?

Oh, joy. This has happened to me on 2 occasions. My first time was actually quite similar to your situation. The tablets were not found in the box and no script could be found. This was a busy pharmacy with a care home upstairs. I phoned the dispensers upstairs but everyone shrugged their shoulders and were of no help. The patient's relative (a terminally ill lady) came in after 5, so surgery was closed. The only things I could fall back on were the CD register and PMR. I considered the last instalment date, number of instalments given out so far, weighed the pros and cons, and decided to dispense the tablets.

Second time, a lady came in for her son's methylphenidate. Again, script was nowhere to be found. This was a much smaller pharmacy (hardly any room to even sit down for a bite) yet a script handed in only a few days previously had managed to go for walkies. I made a few phone calls, and thankfully the surgery went out of their way to prepare a script which I had a taxi pick up. Cost us a pretty penny.