Is there anything else changing in the role of pharmacists other then being able to prescribe?
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Changing roles in Pharmacy
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Re: Changing roles in Pharmacy
Originally posted by miss.mystery View PostIs there anything else changing in the role of pharmacists other then being able to prescribe?
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Re: Changing roles in Pharmacy
You sound disenchanted Raju.
What do you want to see pharmacists doing?
The EPB wants to be proactive with pharmacy and we stated that we wanted to (Sorry for this) think outside of the box.
Post what you want to see or PM me and we can discuss it.
All the bestLinnear MRPharmS
Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.
In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.
For handy pharmacy links try
pharmacistance.co.uk
If you like my posts or letters in the journal try my books!
eloquent-e-tales
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Re: Changing roles in Pharmacy
Originally posted by Linnear View PostYou sound disenchanted Raju.
What do you want to see pharmacists doing?
The EPB wants to be proactive with pharmacy and we stated that we wanted to (Sorry for this) think outside of the box.
Post what you want to see or PM me and we can discuss it.
All the best
I've got no problem with current pharmacist roles but there is just too much hostility and stress placed in the way of us fulfilling our duties. I've got a few things to rant about...so may as well get it over with.
I'd like to see pharmacists do quite a lot of things. But mainly just making pharmacists' every day job less hostile and decreasing the unpaid aspect of our work would increase job satisfaction hugely.
For example, if a GP is 15 minutes car journey away, and they've made a prescription error that needs rectifying, a pharmacist should be able to amend the prescription after a phone conversation with the doctor, provided an audit trail is left on by detailing both the name of the doctor and the pharmacist. Instead we have to jump hoops, or get the patient to. We spend huge amounts of time having prescriber's errors amended, there must be a way to reduce the burden on pharmacists. Giving pharmacists the right to add certain legal aspects to CD scripts was a step in the right direction.
We should be able to do emergency suplies on the NHS like in Scotland.
I would like to see independent and supplementary prescribing in the community. I know we could do some parts of the job better than GPs, like monitoring and tweaking hypertenion treatment, which I see GPs messing up every day. I was checking out the application process for various universities' prescribing courses, and was shocked by the huge amount of red-tape and hostility inherent in them, essentially excluding most pharmacists in the community from being able to succesfully enroll, unless they have a VERY progressive PCT.
I would like to see extemp preparations for certain formulae INCENTIVISED so that pharmacy contractors can earn well out of it and save the NHS millions (e.g. we pay hundreds for things like coal tar solution and dermovate ointment in white soft paraffin, as it saves pharmacist time and we earn more through specials ordering...a pharmacis extemping it would be daft without an incentive...but it raids the NHS coffers like anything to keep the current system). It feels like a waste us having done all this extemp stuff in uni.
We also need some incentives for preventing medicines wastage. Right now I can try and prevent waste, but there is little freedom and no incentive. Why should a pharmacist lose tonnes of money and spoil relationships with the prescribers for NO INCENTIVE. Pharmacists who step out of the norm and try and reduce waste pro-actively are seen as irritating meddlers by patients and prescribers alike, not to mention contractors.
Not having access to medical records makes certain parts of our job very tough and makes expanding our professional role almost imposible.
And not having an Athen's password is insulting... as difficult interventions can be made much easier with information access. I've had to decide whether or not to dispense seeminly off-license medicines (e.g. doses much higher than BNF upper limits) based on little abstracts on papers, decisions that could affect someone's health or get me struck off the register, and decisions which have gone both way.
There are quite a few more things that, might PM you them when they come to mind.
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Re: Changing roles in Pharmacy
Raju,
On the whole I echo what you say.
I too would prefer pharmacy and pharmacists to be rewarded for quality, not quantity- I am being harassed on a daily basis by my employers to churn out as many MURs as possible, I am told in no uncertain terms to "pick patients with only one or two drugs, so it only takes 5 minutes". I am resisting so far, and the Practise pharmacists & surgeries know this and therefore still value my input: when they see my name at the bottom of the form, they know the form is worth looking at.
As for correcting GP's minor errors: I do it regularly, after having spoken to the doctor (or surgery staff) on the 'phone; I just mark the Rx "prescriber contacted by phone", add the time and date, and initial my amendment, along with my RPSGB number. Never come acropper yet. Again, the local GPs know i'm not a time-waster.
The emergency supply-thing like in Scotland is also very high on my wishlist, as I have mentioned in previous posts on this forum over the past 18 months.
I'm not so keen on the extemp preparations: there are simply so many ready-made products available "off the shelf" that I find it hard to justify the need for tailor-made specials, especially at the price that Specials manufacturers are charging! Why is the NHS happy to write out a blank cheque (in effect) to Martindale's for menthol in aqueous cream, but they won't do the same for a Phcy contractor? But even if we were suitably "incentivised" for extemp preparations, I can't see them making a comeback I'm afraid.
Incentives for reducing waste: again, if we weren't paid "by the item", this would addressed...
Athens Account: I've got one, every Phcist in Wales was offered one; what I haven't got is the faintest idea of what I can do with it!!!
Incidentally, why would it be such a bad idea if all Community Phcists were employees of the NHS, like GPs and nurses etc...?Ze genuine Article, present & perfect!
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Re: Changing roles in Pharmacy
Zo
I agree with virtually everything you say, except the 18 month bit - we only started last March.....
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Re: Changing roles in Pharmacy
Originally posted by Zoggite View PostAthens Account: I've got one, every Phcist in Wales was offered one; what I haven't got is the faintest idea of what I can do with it!!!
Originally posted by Zoggite View PostIncidentally, why would it be such a bad idea if all Community Phcists were employees of the NHS, like GPs and nurses etc...?
Anyway, judging by the pay in hospitals, I wouldn't trust the NHS to give the same salary to community pharmacists, especially in the first 10 years after registration. It's all about the bottomline.
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Re: Changing roles in Pharmacy
Originally posted by Zoggite View PostAs for correcting GP's minor errors: I do it regularly, after having spoken to the doctor (or surgery staff) on the 'phone; I just mark the Rx "prescriber contacted by phone", add the time and date, and initial my amendment, along with my RPSGB number. Never come acropper yet. Again, the local GPs know i'm not a time-waster.
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Re: Changing roles in Pharmacy
They say "Be careful what you wish for!"
You've given me plenty to work with here. To be fair some points were already on my possible EPB things to note e.g. Remuneration for services (The whole board has talked about this on many occassions and I don't believe we plan to start any new services without trying to ensure payment first)
The NHS ES in Scotland thing is on my list too.
I have noted all of your comments and will try to add to future debates.
Thanks for your time.Linnear MRPharmS
Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.
In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.
For handy pharmacy links try
pharmacistance.co.uk
If you like my posts or letters in the journal try my books!
eloquent-e-tales
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Re: Changing roles in Pharmacy
Originally posted by Zoggite View PostRaju,
On the whole I echo what you say.
I too would prefer pharmacy and pharmacists to be rewarded for quality, not quantity- I am being harassed on a daily basis by my employers to churn out as many MURs as possible, I am told in no uncertain terms to "pick patients with only one or two drugs, so it only takes 5 minutes". I am resisting so far, and the Practise pharmacists & surgeries know this and therefore still value my input: when they see my name at the bottom of the form, they know the form is worth looking at.
Part of the problem is the same fee is paid, regardless of how many meds the patient is on. How about having a basic fee for the MUR with an additional fee per drug listed. That would increase the incentive to do MURs with those people who are on lots of meds and most in need of an MUR.
Originally posted by Zoggite View PostAs for correcting GP's minor errors: I do it regularly, after having spoken to the doctor (or surgery staff) on the 'phone; I just mark the Rx "prescriber contacted by phone", add the time and date, and initial my amendment, along with my RPSGB number. Never come acropper yet. Again, the local GPs know i'm not a time-waster.
The emergency supply-thing like in Scotland is also very high on my wishlist, as I have mentioned in previous posts on this forum over the past 18 months.
Scotland are far ahead of the game. Emergency supply on NHS would be very useful and might get rid of some of the large number of faxes I get sent.
Originally posted by Zoggite View PostI'm not so keen on the extemp preparations: there are simply so many ready-made products available "off the shelf" that I find it hard to justify the need for tailor-made specials, especially at the price that Specials manufacturers are charging! Why is the NHS happy to write out a blank cheque (in effect) to Martindale's for menthol in aqueous cream, but they won't do the same for a Phcy contractor? But even if we were suitably "incentivised" for extemp preparations, I can't see them making a comeback I'm afraid.
The fee for extemp preps would have to be very high to tempt on site manufacture, but even then you've still got issues around product quality etc.
Originally posted by Zoggite View PostIncentives for reducing waste: again, if we weren't paid "by the item", this would addressed...
Originally posted by Zoggite View PostAthens Account: I've got one, every Phcist in Wales was offered one; what I haven't got is the faintest idea of what I can do with it!!!
Originally posted by Zoggite View PostIncidentally, why would it be such a bad idea if all Community Phcists were employees of the NHS, like GPs and nurses etc...?
And have you looked at pharmacist pay in hospitals? Thats one reason I wouldn't want to be directly employed by the NHS.
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Re: Changing roles in Pharmacy
Steve G,
No, I haven't looked at my Drug Tariff that much this month, I only picked menthol in aqueous cream as an example of extemp because it's the first thing I thought of, but I haven't had a script for a specials cream in ages...
And anyway, as you say, even if I could be persuaded to go back to preparing extemps myself, I haven't got the time, the equipment, or the bench space to do as good a job of them as a dedicated company has.
Raju,
I thought of you today: I had a Rx for loratadine 10mg tablets, "take one once daily at night, quantity: 1 tablet"; out came my ballpoint pen, I crossed out the "1", and stuck a post-it on the script saying "please initial our amendment- Thanks", signed it, dispensed it, before sending it back to the surgery tomorrow. I also often round up the quanities of dressings to full boxes when I know it won't be wasted, for instance when I get scripts for 4 allevyn heel drsgs for Nursing Home patients. I'm sick & tired of silly split boxes of allsorts of dressings that just sit on the top shelf collecting dust, and for which we haven't even been able to claim Broken Bulk because they're officially appliances and not drugs.
Today I also changed a Rx for citalopram 20mg, "10 to be taken daily for stress and anxiety", mitte 28 tablets; Surely one can't be that stressed that one requires 200mg citalopram?Ze genuine Article, present & perfect!
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Re: Changing roles in Pharmacy
Originally posted by Zoggite View PostSteve G,
No, I haven't looked at my Drug Tariff that much this month, I only picked menthol in aqueous cream as an example of extemp because it's the first thing I thought of, but I haven't had a script for a specials cream in ages...
And anyway, as you say, even if I could be persuaded to go back to preparing extemps myself, I haven't got the time, the equipment, or the bench space to do as good a job of them as a dedicated company has.
Raju,
I thought of you today: I had a Rx for loratadine 10mg tablets, "take one once daily at night, quantity: 1 tablet"; out came my ballpoint pen, I crossed out the "1", and stuck a post-it on the script saying "please initial our amendment- Thanks", signed it, dispensed it, before sending it back to the surgery tomorrow. I also often round up the quanities of dressings to full boxes when I know it won't be wasted, for instance when I get scripts for 4 allevyn heel drsgs for Nursing Home patients. I'm sick & tired of silly split boxes of allsorts of dressings that just sit on the top shelf collecting dust, and for which we haven't even been able to claim Broken Bulk because they're officially appliances and not drugs.
Today I also changed a Rx for citalopram 20mg, "10 to be taken daily for stress and anxiety", mitte 28 tablets; Surely one can't be that stressed that one requires 200mg citalopram?
Today we had a locum doc at the local surgery. He didn't know how to use the computer, so every single liquid came up as 420ml (a 28 day thing, 5ml tds). 420ml of amoxicillin, 420ml of paracetamol susp, 420m of simple linctus, ibuprofen susp and all other things, even trimethoprim susp. After doing one or two at 420 ml, I called him to see what the hell's up. He conceded (though very defensively) that it was "the computer's fault", and advised me just to give whatever I felt appropriate. Since it was a reduction in quantity I knew it was Ok to do without his initials, but when its a matter of upping the quantity, us pharmacists are liable to be looked upon as fraudsters so I have to get the doc to change the script. arrrgghhhh.
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Re: Changing roles in Pharmacy
I've lost count of how many scripts for "olive oil ear drops, mitte 2000ml" I've seen... also today I had a lady who had 28 days' supply of 6 drugs, but then also 258 tabs diclofenac 50mg, 1 TDS...?!? That got my ballpoint treatment too, and became 28 days' supply...
I'm getting ever broader shoulders as I near the ripe old age of 40!Ze genuine Article, present & perfect!
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Re: Changing roles in Pharmacy
Originally posted by Zoggite View PostI had a Rx for loratadine 10mg tablets, "take one once daily at night, quantity: 1 tablet"; out came my ballpoint pen, I crossed out the "1", and stuck a post-it on the script saying "please initial our amendment- Thanks", signed it, dispensed it, before sending it back to the surgery tomorrow.
- FP10 has error on
- Pharmacist changes FP10 and initials it
- Sends it back to GP to initial amendment AFTER dispensing
- Pharmacist doesn't get into hot water???!!!
That’s so nice and simple compared to what I’ve seen done in practice:
a) Pharmacist ringing up doctor’s surgery to sort the error and then informing patient to pick up new script from doctor’s surgery and come back with it (cue profanities from patient directed at pharmacist (NEVER the GP)/patient saying they’ll try another pharmacy instead!).
b) Pharmacist has a chat over the phone with GP's secretary and gets dispensing assistant (*cough*) to pick up the script whilst patient waits/plans to return later to collect.
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Re: Changing roles in Pharmacy
Originally posted by hannahd View PostOoooh, I didn't know this was possible! Can I just check whether I've understood this correctly:
- FP10 has error on
- Pharmacist changes FP10 and initials it
- Sends it back to GP to initial amendment AFTER dispensing
- Pharmacist doesn't get into hot water???!!!
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