Puzzled over impending legislation

[novice]

My new neighbour, who is a pharmacist, was telling me a few days ago that the Parliament or the Governement (I'm can't remember which) is trying to make the presence of pharmacists "optional" in the likes of Boots, Lloyds, etc. I must say that I did not quite believe him but he said that it is absolutely true. I am originally from France myself and this would be absolutely inconceivable in France where the Ordre des Pharmaciens is not even allowing supermarkets to sell non-prescription drugs, let alone opening the door to some sort of legislation to get rid of pharmacists in shops. But there are no chains in France, the 18,000 pharmacies are all independent (a cousin of mine owns one). Maybe that is the problem as far as pharmacy is concerned in the UK, I don't know, these groups are so powerful, aren't they? Haven't the UK Pharmaceutical governing body (is it the RSP) the power to stop these laws being even considered, what is going on???

I would like you to clarify a few points on this one as I am confused and would like to understand:

1) What legislation exactly is being discussed in Parliament?

2) Are we talking of legislation that will enable shops to have the prescriptions checked by non pharmacists?

3) What is the Pharmaceutical Society saying about this?

4) What is the PJ saying?

5) Who exactly has the clout in Pharmacy in the UK to stop such legislation being passed?

6) When will it be passed?

7) What do you think will the consequences be short and mid term?

Many thanks in advance for answering my questions, even partly.

[Raju]

Re: Puzzled over impending legislation

The proposal is that Pharmacists can be absent, and certain activities can go on. This does not include the full dispensing of prescriptions, as pharmacists are required by law to do a 'pharmaceutical assesment' of every prescription to make sure it is self. Once a pharmacist had done this 'assesment' a registered technician with accuracy checking status could make and give out the prescription.

Personally, I think it's good if pharmacists can be absent and 'P' medicines still be sold, and prescriptions given out. It would imporve pharmacists quality of life by allowing us to legitimately leave the premises for a few minutes without a pharmacy having to come to an absolute standstill. Also, the public would end up appreciating pharmacists more when we are not there some of the time to give advice.

[johnep]

Re: Puzzled over impending legislation

In the 60s it was widely promoted that the new electronic age would give more leisure. It did, it was called unemployment. be very sure that the law of unintended consequences will mean that the multiples will seize on this to reduce staffing costs. We are unloved and unwanted and will soon go the way of horshoe nail manufacturers.
johnep

[novice]

Re: Puzzled over impending legislation

Thanks, that's useful.

My first reaction is that I would tend to agree with John on this one, although as I said, I am not a pharmacist but a user and this worries me.

I distrust the mighty chains and I, for one, think that your lot (Lloyds, etc.) are run by soap merchants. I am well acquainted with the private sector and to them, in a captive market like pharmacy (in many towns, it is impossible not to use a chain), as long as they manage to put one (cheap) body behind the counter, it is all that will matter soon to many of them.
Hopefully, it won't happen any time soon but I have a feeling this new legislation could be the nail in the coffin for many of you.

It could indeed set a very dangerous precedent and, with a bit more persuading from the all powerful chains to this weak and corrupt governement, open the way to legislation that would gradually and eventually make pharmacists optional.

My second reaction is that I cannot understand how the Pharmaceutical society has OKed this proposal. Does it make sense to you?

The proposal is that Pharmacists can be absent, and certain activities can go on. This does not include the full dispensing of prescriptions, as pharmacists are required by law to do a 'pharmaceutical assesment' of every prescription to make sure it is self. Once a pharmacist had done this 'assesment' a registered technician with accuracy checking status could make and give out the prescription.

RAJU, you wrote: Personally, I think it's good if pharmacists can be absent and 'P' medicines still be sold, and prescriptions given out

OK, I understand, but why would pharmacists be absent from the premises, is it something that often happens?

You say that "prescriptions will be given out" while the pharmacist is away, (presumably given out by technicians/assistants) so technicians will in effect be doing the pharmacist's job for, say, an hour or two, or have I misunderstood? Aren't pharmacists legally responsible in case of mistakes?

As a member of the public, I find this proposal worrying, I do not want my prescriptions to be checked by anyone else but a pharmacist, is that what's going to happen? I fear so.



What about these Qs below in my OP, any takers?

1) What is the Pharmaceutical Society saying about this?

2) What is the PJ saying?

3) Who exactly has the clout in Pharmacy in the UK to stop such legislation being passed?

4) When will it be passed?

5) What do you think will the consequences be short and mid term?

[Raju]

Re: Puzzled over impending legislation

RAJU, you wrote: Personally, I think it's good if pharmacists can be absent and 'P' medicines still be sold, and prescriptions given out

OK, I understand, but why would pharmacists be absent from the premises, is it something that often happens?

Just to get a sandwich or to get your car fixed or other small things. Otherwise, 9-6.30pm in the same place every day can get in the way of normal life - having to get a whole days locum for a job that may take just half an hour - what a waste of money.

Anyways - maybe you are right that it will affect pharmacists negatively in some ways too. But right now the tiring and stressful nature of my job (shared by most pharmacists) makes me kind of gladdened by the prospect of being able to take short brakes without the services coming to a flat halt.

By the way - I don't think Pharmacists employment will suffer much. Pharmacies that reularly have no pharmacist for significant amounts of time will lose popularity and patients fast - from what I have glimpsed. The speed of service, and the level of advice will be reduced. And seeing that, people will choose pharmacies with a pharmacist present.

[johnep]

Re: Puzzled over impending legislation

One of the reasons I got out of retail was the fact that 'four walls doth a prison make'.

as I looked out of the window at the turqoise sea from my hotel in Miami, I thought now where would I rather be, at risk of making an error in dull rainy chemist shop in UK, or looking forward to a 3-4 week tour of the caribbean calling on what sometimes became very good friends.

Now I am back in retail jail, but have my memories.
johnep

[Linnear]

Re: Puzzled over impending legislation

The English Pharmacy Board was shown the new skill mix document and asked to comment.


Some points made:

The disappearance of the pharmacist should be under exceptional circumstances only.

The superintendent pharmacist is mentioned very early in the document as ultimately responsible


I pointed out that these two, regardless of how many changes are made before it gets into legisaltion should remain carved in stone to stop unscrupulous companies sending pharmacists out here there and everywhere.

The people actually getting the documents written said they were aware of this possible problem and weren't going to alter it.



The giving out of Rxs while the pharmacist is away would purely be the completed bagged up ones.



One point has been raised for me to forward to the group. The document says that only clinically changed Rxs need to be clinically assessed by the pharmacist and this basically gives us one chance to get any clinical problems sorted out.
This raises problems if an antibiotic Rx gets repeated or what if clinical goalposts are moved? I remember when it didn't matter what fruit juice you drank with breakfast.


If you do have anything you want raised then email me at the link below and I'll try to get a vox pop report sent to the team working on it.

[novice]

Re: Puzzled over impending legislation

Thanks for all your comments, very useful and reassuring on the whole for everyone involved, inc. users of course.
I think I now understand the new impending legislation better than my neighbour who is a pharmacist!

I am still puzzled as to the reasons why exactly this new legislation was needed in the first place. Surely, the way it works now (assistants + pharmacist to check) is fine as it is, or am I missing something?

Was this legislation thought of because pharmacists were asking for more flexibility during working hours, eg popping out for 10 minutes?

The thing that I don't understand either is, if the pharmacist is ultimately legally responsible for what goes out of the shop, why would this pharmacist let someone else check the prescription? (or have I misunderstood sthg?).

[Linnear]

Re: Puzzled over impending legislation

Your last paragraph touches on the possible problem with allowing Accuracy Checking Technicians to check Rxs.

I assumed that the whole legislation regarding ACTs allowed for them to check Rxs that the pharmacist had already clinically checked. This is the case but if the ACT does make an error the pharmacist would probably still be held liable.

In which case allowing them to check the Rx is a very dodgy practice indeed.

Our next meeting is going to have someone from Lambeth legal there to explain it to us and so we can ask questions.

Will get back to you on it.

[novice]

Re: Puzzled over impending legislation

Thanks Linnear.

Do you know why this new legislation was needed at all. Isn't the way it is working now (assistants + pharmacist to check) fine?

Who pushed for it?

[Linnear]

Re: Puzzled over impending legislation

It's all part of the push for more clinical roles for pharmacists. If we're tied to the dispensary bech 24/7 then making the most of these new roles will be difficult.

I believe that some lee way is required, after all how many times have you had the message, the Drs surgery is closed due to staff training? When I was a pre-reg the local surgery was working on one locum receptionist and one locum Dr for a whole afternoon for a staff meal!

I don't believe that the pharmacist should be able to regularly leave the dispensary but the option should be there for exceptional circumstances.

The one thing that always bugs me is the staff not being able to give out Rxs during my break. I'm not going to check them again so why shouldn't they go out?

Will be keeping a close eye on it though and will keep you informed.

[novice]

Re: Puzzled over impending legislation

OK, thanks. When would the legislation be passed you reckon?

[Linnear]

Re: Puzzled over impending legislation

No real timeframe laid down to us but usually takes about 2 years (sometimes longer) to get legisaltion ironed out and implemented.

[Pharmanaut]

Re: Puzzled over impending legislation

No real timeframe laid down to us but usually takes about 2 years (sometimes longer) to get legisaltion ironed out and implemented.

In that time we can see how the landscape looks with all the other changes that are stacking up.

I haven't got a problem with staff handing out checked prescriptions if I'm in the back having lunch. If the customer has a query then I can pop round and answer it. If we need to mention something to a customer we put a note on the bag, again if they have a question I'm there. I realise there are a few who do not take their professional duties seriously - but why do those of us who do have to be tarred with the same brush.

[Jeff]

Re: Puzzled over impending legislation

Thanks Linnear.

Do you know why this new legislation was needed at all. Isn't the way it is working now (assistants + pharmacist to check) fine?

No.
I want the ability to delegate as I see fit.
(N.B that is not the same as the proposal that pharmacies can operate without a pharmacist present - full stop - but that the pharmacist should be allowed to leave the premises and allow dispensing to continue (or allow dispensing without a pharmacists check) - when the situation justifies it - subject to the pharmacist accepting the responsibility for doing so.)

Examples of "when the situation justifies it"
1.Patients partner needing to cry on my shoulder
a) because patients kidney is failing and they've been told that they are too old for another transplant.
b) because they've heard about NICE guidelines and think that their partners Aricept will be stopped and that the hallucinations will come back.

2. Patient's need to talk
a) 12 year old - home alone - and just had a positive pregnancy test.
b) Lady who has been "forced upon" by a relative and can't see her family doctor.

My instructions to my dispenser "Dispense the ones you're happy with and tell the rest to come back later"
I'm happy to accept responsibilty for any errors made while I'm doing something else - but not happy that I might be breaking the law even if there are no errors.

Who pushed for it?

Probably multiples who believe that they can function more profitably with fewer pharmacists.

Jeff