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  • independant pharmacist prescribers

    I recently came across a private prescription generated by an independant pharmacist prescriber, from what seemed to be a private practice. I would appreciate your views on this. Does anyone know of other privatly prescribing pharmacists? What is the legal and ethical stance on this? It seemed a rather commercial enterprise to me, however I'm not sure on it's legal validity. As I understand it, is not the case that independant pharmacist prescribers are restricted to prescribing in certian conditions? Do they also not have to prescriber within a certian PCT/ practice?

    Seasons greetings to all, and a happy new year

  • #2
    Re: independant pharmacist prescribers

    I am an independent prescribing pharmacist. We can write prescriptions for anything in the BNF. Controlled drug prescriptions require a clinical management plan but there is no requirement for a dispensing pharmacist to have sight of it. It will shortly be the case that controlled drug scripts won't need a CMP.

    As for how you can check, the RPSGB website will have an annotation next to the name. If you look my name up (my registration number is 70828) you will see "IP" next to it and a supplementary prescriber would have "sp" next to their name.

    Prescriptions can be written for anything but you need to demonstrate a competency in the therapeutic area. That would be to the RPSGB or the PCT. However a private prescription is not covered by the PCT but is regulated by the Health Care Commission. If you have concerns contact them.

    What do you mean it was a "commercial enterprise?" My gut reaction is "good for them"!

    What were the circumstances?

    Prescribing pharmacists are going to become more common. Why don't you do the qualification?
    http://uk.youtube.com/watch?v=Hmbyj0XFUhA

    Comment


    • #3
      Re: independant pharmacist prescribers

      Thanks for the reply Tony,

      I wasn't passing any negative judgement on this pharmacist, actually I was quiet impressed with the set up. It seemed as though the individual gave private consultations, as well as prescribing privately to patients. From what I understand there is also a large demand for his services. He had a private script pad with his registered company and private practice address.

      Would I be right in thinking, this could possibly be a service availabe at pharmacies in the near future? Or is it already the case (private prescribing)?

      I would also appreciate some further information on where to begin for further qualifications in independant prescribing.

      Comment


      • #4
        Re: independant pharmacist prescribers

        If you look at my postings in the time I have been contributing here I have continually advocated pharmacists acquiring new skills. I suggest prescribing and a clinical skills course.

        Contact your nearest School of Pharmacy if you are interested.

        Of course this is the future.

        There has been much negative nonsense about the future for pharmacists and worries about jobs as managers reaching saturation. Even if it were true so what? The future opportunities are immense and thankfully you have seen that to be the case. I can tell you categorically that the pharmacist you have just encountered will not be worrying about £25 per hour
        http://uk.youtube.com/watch?v=Hmbyj0XFUhA

        Comment


        • #5
          Re: independant pharmacist prescribers

          so is the independant presciber based in the pharmacy or in a PCT or private practice.


          So if one is to open a pharmacy will they be able to prescribe and despense form the same pharmacy.

          In the future do you think PCT and private practices will recruit pharmacist just for prescribing and consultations.


          Thanks

          Comment


          • #6
            Re: independant pharmacist prescribers

            Originally posted by student View Post
            so is the independant presciber based in the pharmacy or in a PCT or private practice.


            So if one is to open a pharmacy will they be able to prescribe and despense form the same pharmacy.

            In the future do you think PCT and private practices will recruit pharmacist just for prescribing and consultations.


            Thanks
            The independent prescriber is independent and independently will be located where most required.

            Pharmacists who prescribe can dispense their own prescriptions but of course it is not a good thing to encourage. There are governance procedures in MEP and, for instance when I prescribed in my pharmacy, I ensured that an ACT checked before administering/supplying. In my case it was subutex or methadone so it was administered supervised on the premises.

            As independent prescribing pharmacists are independent they wouldn't necessarily look to be recruited, they are free to "set up" wherever they wish. However, I see many possibilities for pharmacist prescribers being recruited. Incidentally, PCTs will be doing less recruiting. It is government policy for PCTs to commission services from providers not for the PCT to provide. It is these providers amongst whom the opportunities will present.
            http://uk.youtube.com/watch?v=Hmbyj0XFUhA

            Comment


            • #7
              Re: independant pharmacist prescribers

              so if they free to set up where they want.

              who pays them?

              how does it work?

              where do they earn the money?


              approx how many years is the course and can you do it straight after registration.


              Thanks


              Comment


              • #8
                Re: independant pharmacist prescribers

                whats the diffrence between suplementry and independant prescriber?

                is supplementry when the pharmacist does not make a diganosis and independent is when the pharmacist does...


                sorry if im asking alot of questions..

                im just intrested

                Comment


                • #9
                  Re: independant pharmacist prescribers

                  Originally posted by student View Post
                  so if they free to set up where they want.

                  who pays them?

                  how does it work?

                  where do they earn the money?


                  approx how many years is the course and can you do it straight after registration.


                  Thanks


                  They will get paid for their services by whoever employs them. If it is a private arrangement, the patient would pay them directly. If they work for a commisioned service, that service would pay them. There are pharmacists who contribute here who work in doctor's practices and are paid by the practice. I am unsure as to whether they get more for prescribing but clearly a prescribing qualification makes them more employable. There are companies who advertise in the PJ to recruit staff to work in medicines management.

                  The course, with appropriate time with a mentor takes between 3 and 6 months. You need to have been a practicing pharmacist for 3 years before you can do it.
                  http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                  Comment


                  • #10
                    Re: independant pharmacist prescribers

                    Originally posted by student View Post
                    whats the diffrence between suplementry and independant prescriber?

                    is supplementry when the pharmacist does not make a diganosis and independent is when the pharmacist does...


                    sorry if im asking alot of questions..

                    im just intrested
                    Supplementary prescribing came about as the initial pharmacists and nurses were allowed to prescribe. All prescribing required a clinical management plan and had to be within a defined competency framework. Independent prescribing superceded supplementary prescribing and I think all courses are now for independent prescribing. You can convert of course.

                    Diagnoses can be made by an independent prescriber but you need to be damned sure that your clinical skills are up to scratch. Courses exist to give you such skills but keeping them up to date is a different story. I find it works best as part of a team including doctors and nurses where all skills are available to the benefit of the patient.

                    Before anyone goes off and complains that nurses will be employed ahead of pharmacists because they are cheaper it isn't true. Pharmacists look at clinical issues from a "big picture" stance as they are used to looking for drug interactions. Managing co-morbidities is much more our thing than nurses who are protocol driven and tend to look at each symptom in isolation.

                    There will be many new prescribers, opticians, chiropodists etc but I am unsure what their status is or what formulary they will work from. I know of a podiatrist who manages insulin dependent diabetics as a supplementary prescriber.

                    Don't worry about asking questions, that is why sites such as this exist. However the DOH, PSNC, RPSGB websites, amongst others, have a lot of information on non medical prescribing which you are able to look up for yourself. What you may not freely access is suggestions as to how to commercially exploit prescribing as people don't wish to disclose their commercial plans.
                    http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                    Comment


                    • #11
                      Re: independant pharmacist prescribers

                      hello Mr TS
                      as an IP i assume you prescribe from your own pharmacy, do you have access to patients notes and complete medication history?
                      d oyou have all the facilities to issue NHS scripts (prescription pad, IT....etc) or you only issue private scripts from your own pharmacy?

                      Regards
                      [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
                      [/COLOR]

                      Comment


                      • #12
                        Re: independant pharmacist prescribers

                        Thank you for the excellent information Mr Schofield. This is the reason why I first registered to this site. I'm a relatively new pharmacist and pharmacy owner. I have now started the ground work to gain my qualifications in independant prescribing. I thank you again.

                        Comment


                        • #13
                          Re: independant pharmacist prescribers

                          Originally posted by Raoul View Post
                          hello Mr TS
                          as an IP i assume you prescribe from your own pharmacy, do you have access to patients notes and complete medication history?
                          d oyou have all the facilities to issue NHS scripts (prescription pad, IT....etc) or you only issue private scripts from your own pharmacy?

                          Regards
                          I no longer prescribe from the pharmacy. I am part of a community interest company that won a contract to provide drug services to a PCT. The prescribing budget is in the name of the new service and my prescriptions are written on their pads.

                          I also have a contract with a GP surgery to provide alcohol and opiate detoxes to a community rehab facility. I have my own prescription pad in the name of the surgery. This work takes a couple of hours at a time once or twice a week and is the sort of thing that any community pharmacist could leave the premises under RP legislation to perform.

                          I don't issue any private prescriptions but have toyed with sexual health, weight reduction and vaccination sessions in the pharmacy. Others are doing this.

                          With regard to the NHS work I do I have access to the patient's record as held by the service I work in. It may not include the complete medical history of the patient. However other specialist services locally:- diabetes and muscular skeletal for example are in the same situation. In all cases, the service, including ours works with the practice and expects an up to date medical picture. It is more complex with drug misusers as they are usually chaotic when they come into treatment.

                          Private prescribers rarely have access to full medication histories.

                          I must make it clear that I don't see pharmacy prescribers as full time competitors to doctors. I do see them, with their superior positional locations, being able to do much work that doctors surgeries do eg manage long term conditions and assist in reaching local/national targets for say obesity. This releases the GP to do work they currently send people to hospital for which in term improves outcomes and reduces waiting lists.
                          http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                          Comment


                          • #14
                            Re: independant pharmacist prescribers

                            Originally posted by Averroes View Post
                            Thank you for the excellent information Mr Schofield. This is the reason why I first registered to this site. I'm a relatively new pharmacist and pharmacy owner. I have now started the ground work to gain my qualifications in independant prescribing. I thank you again.

                            Old "has beens" and "never really beens" like me owe it to young pharmacists to help them progress. Please feel free to contact me at any time. I may not have the right answer but at least if you reject what I say you will have thought about it and considered it first.

                            Where are you based? Answer in "pm" if you wish.

                            Good luck. You have the spirit that is required. I am sick of hearing that the only future for pharmacists is in management for one of the multiples. You are truly an inspiration.
                            http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                            Comment


                            • #15
                              Re: independant pharmacist prescribers

                              Originally posted by Tony Schofield View Post
                              I no longer prescribe from the pharmacy.






                              I must make it clear that I don't see pharmacy prescribers as full time competitors to doctors. I do see them, with their superior positional locations, being able to do much work that doctors surgeries do eg manage long term conditions and assist in reaching local/national targets for say obesity. This releases the GP to do work they currently send people to hospital for which in term improves outcomes and reduces waiting lists.
                              so in the future do you believe that IP could manage people with chronic conditions, which would free the time of GPs to deal with new patients? an example is working in a GP surgery 2-4 hours/week, dealing with asthma patients, ammending the dose and prescribing new drugs for them if needed?

                              i have to admit it this sounds very interesting, but not sure how competent someone could be after doing the 6 months IP course. but as you said nothing to loose, if someone does not feel competent he can always go back to take a management role or locum.
                              Thanks Tony ( is it ok to drop the Mr )

                              what you do sounds interesting and i bet satisfying as well.


                              about the private prescription bit, would it be commercial satisfying if an IP run an in-store clinic on Saturday so that patients will not travel 10s of miles to OOH to get a script, if they are willing to pay? does it sound like a good idea for the future or a bit risky ( if commercial needs override the IP competency)?


                              about precribing for substace-misusers, does this means you can manage any situation on weekends for mis-issued scripts/dose adjustment? this would make the whole system runs smoothly as the prescriber is the person in control of the pharmacy going to dispense the daily script. am i right?


                              i guess it all comes to communication with other H.care professionals and taking the chance whenever possible.

                              thanks again for all the explanation, not sure if i am the right person for the IP qualification, as i do have the tendency to pay more attention to financial/commercial issues and i do not want to fall into 'conflict of interest' issues if i am a prescriber and a dispener (once i start my own pharmacy )
                              [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
                              [/COLOR]

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