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  • Faxed prescription + verbal attack by another healthcare profession

    post has been deleted


    Last edited by stawberry; 5th, January 2018, 09:34 AM. Reason: legal reason

  • #2
    Oh dear...Has happened to me with methadone scripts and delayed post. People are very keen for you to break the law on their behalf.
    johnep

    Comment


    • stawberry
      stawberry commented
      Editing a comment
      Thanks Johnep for the reply. I have learnt in a hard way, not going to do it anymore in future.

  • #3
    The problem is that the basic prescription laws have not kept up with modern communications.
    Unless this kind of thing occurs to someone in an influential position nothing will be done.
    There are plans to put private prescriptions on EPS in England - eventually.
    However the S2/S3 scripts are due to go live soon for NHS and there will be problems that need to be ironed out that stem from that transition.

    In the meantime - go forth and do a CPD entry on this and reflect what you would have done differently.

    If you agree to do something for patient benefit that breaks the rules emphasise to the prescriber that this is totally discretionary and cannot be used to set a precedence.

    What is the difference between a genuine emergency and a situation resulting from a total lack of planning from people who have a chaotic lifestyle and bear down on people to help them all the time at the drop of a hat? This applies to both patients and professional people. I'm happy to help in an emergency but chaotic lack of planning is not my responsibility.

    Most of the time the internet is full of daft opinions and views that you should not take seriously let bother you at all.
    Note : If this posting contains personal views or opinions every endeavour is made to ensure they stay within social media guidelines.
    If you find you have read something that has upset or offended you an anyway please unread it at once.

    Comment


    • stawberry
      stawberry commented
      Editing a comment
      Hi Pharmanaut thanks for your reply. I have had conversation with the patient rep and realised that the request by the actual patient was only made to the Addiction Team on the same Saturday that the GP made the phone call to me. So it is basically the patient's fault as well for having the last minute request and obviously both GP and the Addiction Team had pushed it last minute.
      Last edited by stawberry; 4th, January 2018, 07:58 PM.

  • #4
    Another point of view.

    If the psychologist was threatening they were breaking the law. Get the store manager to ban them from contacting the store.

    Contact their regulator. Point everything and this out.

    Comment


    • #5
      One of the problems with pharmacists is that we are a bit too nice and eager to help patients, but other professionals do see us as jobsworths because we stick to the rules. Personally, I'd put in a formal complaint against the psychologist for threatening behaviour, but I can understand why you might not want to do that.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Thanks for your understanding. Yes I really eager to put a formal complaint and I am looking into how to complain. However, I am not used to do this and I am afraid that I am ended up with guns pointing back to me.

        So what? Dont be afraid. This is the problem some pharmacists are so scared they put up with poor conditions and unrealistic ecpectations. Tell people ehy you think what they are ecpecting from you is not legal. Just be brave guys and speak up. If we all retrieved to a corner shaking and scared then you are a victim no one will help you your employer will not side w you for breaking the procedure. Are u with a union?
        Last edited by Primrose; 7th, January 2018, 01:17 PM.

    • #6
      Difficult situation. You agreed to dispense on the back of a fax. Your primary consideration was the patient. You supplied the first instalment, with the second onl becoming due if the addiction centre deemed supply appropriate. You didn't allow for the Bank Holiday post. Your discussion with the GP was to do with posting of the script. Once you had satisfied yourself that the GP had done their bit, it was now down to the Post Office. You said the GP ws reasonable so no problem in getting a replacment Rx if things had gone pear shaped.
      The onus was on the treatment centre to contact YOU to confirm/deny supply of the second instalment. Instead you get a phone call, jumping the gun, prattling on about refusing to supply?? Look. No need to give up the day job. Think things through properly at the onset. What are you prepared to do? Spell it out in plain English. Stick to it.
      Sounds to me that you got fixated with receiving the Rx and made that the central issue and overlooked the basic agreements made prior to initial supply.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Hi viru219 thanks for your reply. I admit I have been too optimistic about the delivery as I trusted what the GP said to me over the phone and not justifying about the time I get it. Should have allowed myself some time to think before I said anything else.
        Yes I do agree the team should have rung us back and they didn't in the first place. But I was worried for getting penalised as the post didn't arrive on time.
        Yes I forgot to take bank holidays into the consideration in this case and I think this also suggests that I am inexperienced dealing with faxed scripts as I don't do it usually.
        Last edited by stawberry; 4th, January 2018, 09:13 PM.

    • #7
      Just to clarify, the psychologist that rang you is from the Addiction Team that was supposed authorize the next installment right?

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Hi Lefty thanks for your reply. Yes they are supposed to ring me in advance.

    • #8
      Report them to as high up as you can get. Just being able to give them a fright, or make them think twice about such incidents in future , means it'll be worth it.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Hi pharmer7 thanks for the reply. I have been encouraged by my team members to do so but at the same time I might be putting myself at a vulnerable position too? Don't really want GPhC to think I always dish out scheduled items like this.

    • #9
      I recall the last time we chased down a prescription for diazepam rectal tubes for an epileptic child the receptionist commented... "you pharmacists will do anything to get a prescription to dispense".
      Not sure if that was a compliment or a derogatory remark.
      The patient's parent was very grateful - so we were happy with that.

      Anyway ... if anything goes wrong these days you get hauled over for not following the SOP.
      So just follow the SOP and if anyone complains you can't be faulted for following the SOP.
      Most of the time the internet is full of daft opinions and views that you should not take seriously let bother you at all.
      Note : If this posting contains personal views or opinions every endeavour is made to ensure they stay within social media guidelines.
      If you find you have read something that has upset or offended you an anyway please unread it at once.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        I agree with the SOP especially when you have to be extra careful with what you doing these days. But we will still be shot with the ethical side of our action - best interest of patient?

    • #10
      A really unfortunate position to find yourself in. A hard line against any schedule 2-4 drugs dispensed against a fax is the only way to go. We can talk best interest of the patient as much as we like but the out of hours GP could and should have managed this situation.

      The psychologist was completely in the wrong threatening you but in all due fairness you're not entirely on the right side having essentially dispensed chlordiazepoxide without a prescription.
      I remember when a blog was an individual boot.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Hi Ninmrec thanks for your reply. I agree it was completely wrong to allow them to frighten me. I am not trying to defend myself and I know I have broken the law in this case and the worst is I don't get the appreciation from the Addiction Team for the help. May be you could go back to my first few paragraphs of my story and check I did consider having normal FP10 and I did suggest to the relevant prescriber too? Many thanks.

    • #11
      Originally posted by Nimrec View Post
      A really unfortunate position to find yourself in. A hard line against any schedule 2-4 drugs dispensed against a fax is the only way to go. We can talk best interest of the patient as much as we like but the out of hours GP could and should have managed this situation.

      The psychologist was completely in the wrong threatening you but in all due fairness you're not entirely on the right side having essentially dispensed chlordiazepoxide without a prescription.
      I don't see a problem with making the supply. It was an emergency supply at the request of a prescriber for a sch 4, so whats the issue?

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Thanks Lefty this made me feel a bit better. I always double check the latest regulations for the scheduled items before making any decision like this.

    • #12
      The psychologist was completely in the wrong. Threatening another individual in such a way (be it another h/c professional or member of the public) can land him or her in serious trouble if you decide to press the matter. Not only that, if I was spoken to by a prescriber who I wasn't familiar with, I would have reason to suspect that the person isn't who he claims to be or had ulterior motvies. I'm sure there are cases where a phone call from an addiction prescriber turned out not to be genuine.

      My advice is to write a letter to this prescriber's superior within the addiction unit (find out what the hierachy is in that work place), with the following concerns:

      1) He was attempting to prescribe a substance that falls under the Misuse of Drugs act without a valid prescription, which is not essential but legally questionable unless adequate reasons are provided
      2) He was attempting to force another h/c professional to be an accomplice to this activity
      3) His failure to furnish a valid prescription constitutes a breach of the law
      4) By not furnsihing a valid prescription and ensuring it reached the patient in time, he was not exercising responsibility as a prescriber
      5) He was careless and didn't exercise due diligence when dealing with an issue involving controlled substances used for addiction
      6) He accused you of acting unethically, which is highly inappropriate for someone in his position and an attempt to divert responsibility
      7) He caused you great distress by being verbally abusive (emphasising that other members of staff were present and witnessed you taking the phone call).
      8) The management within your pharmacy has been made aware of this incident and it has been documented
      9) The local GP is aware that this incident took place
      10) Ask that the practice manager (or equivalent) speak to the prescriber and make him aware of these concerns.

      Remember, all work places are required to address complaints and the person making the complaint is entitled to a satisfactory response within 30 working days. Stress that you're entitled to write to the GMC and begin a process that could likely lead to fitness to practice proceedings.

      Comment


      • stawberry
        stawberry commented
        Editing a comment
        Hi kl06229, thanks for your reply. I like the way you point things out in bullet points with proper sequence as it makes things easier. However, just to rectify couple of points. The actual GP who prescribed the chlordiazepoxide is actually employed by the Addiction Unit and the psychologist who threatened me over the phone is actually the DIRECTOR of the Addiction Team when I followed up the case with the GP. The practitioner psychologists do not have actual prescribing right. However I will use the Points 1 to 8 from your reply which are quite helpful to me thank you so much.

    • #13
      post has been deleted
      Last edited by stawberry; 5th, January 2018, 09:35 AM. Reason: legal reason

      Comment


      • #14
        Originally posted by stawberry View Post
        The worst thing is this person is quite popular senior specialist who writes blogs regularly and gets interviewed by BBC radio over addiction issues. Feel I am in quite vulnerable position at the moment if I am to file a formal complain.
        That's even better - he won't want anything harming his precious reputation.

        Comment


        • #15
          Originally posted by stawberry View Post
          Hi guys thank you so much for all replies. They mean a lot to me and I feel a lot better now. Just find out this practitioner is actually called psychotherapist not psychologist which is different from what I thought. Not quite sure what is the difference between the two. Looks like psychotherapists are registered with BACP while practitioner psychologists are registered with HCPC. The worst thing is this person is quite popular senior specialist who writes blogs regularly and gets interviewed by BBC radio over addiction issues. Feel I am in quite vulnerable position at the moment if I am to file a formal complain.

          Last question is will you inform PDA and ask for their advice?
          I would definitely inform the PDA, primarily for advice on your legal position as a professional if being pressured into dispensing Schedule 4 meds in this kind of situations. Whether or not the PDA can directly influence the prescriber and addiction unit to prevent future occurrences is uncertain but I strongly believe the advice the PDA gives would be to refrain from dispensing the meds and keep yourself safe (professionally and legally). In any case, it means this will be documented by another organisation if the prescriber feels gutsy enough to pursue you.

          On the subject of that, I doubt he will pursue you. This is based on the simple fact that he would be incriminating himself since it would become apparent he was breaking the law and breaching professional standards (see my list of points). It's easy to panic and end up being distressed when being pressured the way you were, but it's crucial to refrain from anything which you think is a foolish move for you as a professional, compose yourself and simply refuse. If the prescriber has any common sense, he'll likely realise the same thing after he calms down and will be eager not to pursue the matter any further. For him, it's in his self interest.

          For you, the ball is in your court. You'll have a recollection of the phone call (which you seem to recall very clearly, but put it down in detailed writing) and so are in a position to file a complaint, to whoever it needs to be. From your post, it sounds like you work for a multiple, so there is the risk that your employer may take steps to please a doctor who sounds like a bit of a celebrity within his field. Personally, I have been reprimanded in my days working at Boots when I talked back to a rude doctor. My line manager was a horrible woman, who was of the "I'm right and you're wrong, I'm big and you're small" persuasion so anything I did was wrong no matter what. Of course, you have rights as an employee and your employer wouldn't want a story breaking out that they hushed a pharmacist for doing her job to pacify a male doctor acting like a twat (especially when the meds in question were for an addict, and the public begrudge their tax going to addicts).

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