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  • MDS problems

    1) Husband usually prepares dosette box for wife.
    2) Husband goes into hospital.
    3) carers not allowed to administer medicines except from MDS system.
    4) Carers ask chemist who originally supplied medines to put into dosette box.
    5) Chemist says will only do on payment of upfront £40 charge and £5 per month.
    6) Carer 'phones us to say dosette box wanted urgently, we have no record of pt on PMR and no script.
    7) Carer comes in with dosette box and packs of medines and wants us to put into dosette box.
    8) We explain cannot be done as once medicines left pharmacy cannot be repackaged.
    9) We ask carer to obtain script from surgery and we can then dispense directly into dosette box.

    Was our action correct?

    johnep.

  • #2
    Re: MDS problems

    Originally posted by johnep View Post
    1) Husband usually prepares dosette box for wife.
    2) Husband goes into hospital.
    3) carers not allowed to administer medicines except from MDS system.
    4) Carers ask chemist who originally supplied medines to put into dosette box.
    5) Chemist says will only do on payment of upfront £40 charge and £5 per month.
    6) Carer 'phones us to say dosette box wanted urgently, we have no record of pt on PMR and no script.
    7) Carer comes in with dosette box and packs of medines and wants us to put into dosette box.
    8) We explain cannot be done as once medicines left pharmacy cannot be repackaged.
    9) We ask carer to obtain script from surgery and we can then dispense directly into dosette box.

    Was our action correct?

    johnep.
    5) Original chemist should help as a one-off to get over immediate worry and then get weekly scripts until husband is back in action, with spare medicines put at one side until then. Put yourself in the position of a distressed patient - it might be you one day (rhetorically speaking).
    9) Your action is correct in all ways.
    47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
    2018 AD : Modern Man : I shopped, I clicked, I collected.
    How times change.

    If you find you have read something that has upset or offended you an anyway please unread it at once.

    Comment


    • #3
      Re: MDS problems

      My first reaction was to fill the tray with the otherchemist's medicine. However, if anything went wrong , who would be to blame. I remembered my assistant who would never help anybody in case it went wrong and he was blamed.

      Of course, if the local authority employed qualified staff instead of cheapest available, then they could give the medicines. Ie they expect us to break the rules so that their staff do not have to.
      johnep

      Comment


      • #4
        Re: MDS problems

        Originally posted by johnep View Post
        My first reaction was to fill the tray with the otherchemist's medicine. However, if anything went wrong , who would be to blame. I remembered my assistant who would never help anybody in case it went wrong and he was blamed.

        Of course, if the local authority employed qualified staff instead of cheapest available, then they could give the medicines. Ie they expect us to break the rules so that their staff do not have to.
        johnep
        That's why I back off being as helpful as I used to be. Even when giving first aid - its at the back of your mind.
        It would be a good advertising slogan - "Bring your scripts to XYZ Pharmacy, we break the rules so you don't have to"
        47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
        2018 AD : Modern Man : I shopped, I clicked, I collected.
        How times change.

        If you find you have read something that has upset or offended you an anyway please unread it at once.

        Comment


        • #5
          Re: MDS problems

          John, I would say that you've done all you can.

          I definitely would not repackage another pharmacy's tablets.

          If only from a pragmatic point of view if you put those tabs into the dosette box, which is a time consuming operation and opens up all sorts of chances of litigation. How are you being paid? You're not.

          Originally posted by Pharmanaut View Post
          5) Original chemist should help as a one-off to get over immediate worry and then get weekly scripts until husband is back in action, with spare medicines put at one side until then. Put yourself in the position of a distressed patient - it might be you one day (rhetorically speaking).
          I would agree in principle Pharmanaut but what if the original pharmacist knew that the doctor would not write a 7 day Rx? Some won't. I know a number that won't write a single MONTH Rx.

          You're supposed to fill four or even eight dosettes for 90p per item. I'd charge too.
          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

          Comment


          • #6
            Re: MDS problems

            Yes you are correct. Local Drs refuse to write 7 day scripts and expect us to fill four trays for one fee. However, SD advertise free MDS service and free delivery so guess we are in a no win situation. Free delivery offered as well.

            It is all an attempt to increase script count.
            johnep

            Comment


            • #7
              Re: MDS problems

              Originally posted by Linnear View Post
              I would agree in principle Pharmanaut but what if the original pharmacist knew that the doctor would not write a 7 day Rx? Some won't. I know a number that won't write a single MONTH Rx.

              You're supposed to fill four or even eight dosettes for 90p per item. I'd charge too.
              Hang about - the GMC have advised that GP's should issue scripts for a duration that is clinically appropriate and not for the convenience and profitability of pharmacists.

              The use of MDS containers is down to the judgement of the pharmacist and not to the judgement of carers, GP's or anyone else. (But might be challenged under the DDA)

              If not in the pharmacists judgement "needed" but wanted anyway - for the convenience of carers etc, then charge as much as you can get away with. If in your judgement it's needed - the fill the boxes and accept the 90p - you don't at that stage have a choice.

              NB - transferring patients own medicines to an MDS container is a no no. (NPA advice)

              Jeff

              Comment


              • #8
                Re: MDS problems

                Originally posted by johnep View Post
                3) carers not allowed to administer medicines except from MDS system.
                johnep.
                So what happens if the patient has Movicol sachets, Adcal-D3, Risedronate Once-a-week tablets, MST-cont, Transiderm patches, Ikorel 10mg BD, and a meloxicam suppository?
                Oh, and I forgot the Oestrogel and the Lantus opticlick...And the paracetamol tabs PRN...
                Ze genuine Article, present & perfect!

                Comment


                • #9
                  Re: MDS problems

                  Don't foget the glycerin suppositories and canestan pessaries!
                  johnep

                  Comment


                  • #10
                    Re: MDS problems

                    Originally posted by Jeff View Post
                    Hang about - the GMC have advised that GP's should issue scripts for a duration that is clinically appropriate and not for the convenience and profitability of pharmacists.

                    You make me laugh sometimes Jeff.

                    The GMC also says that Drs shouldn't write Rxs for family members.
                    That Drs shouldn't write CD Rxs for more than 30 days supply. (I know GMC didn't bring that in but you get my point)
                    That Drs shouldn't prescribe anti-malarials on FP10.
                    That Drs shouldn't write Temazepam Rxs for more than 10 days. (Again not GMC)

                    I did an MUR talk for a surgery the other day and one Dr was talkign about taking my MUR paperwork (10-30 mins depending on content and £25) and using it for HIS patient reviews. (No work and probably £50-75).

                    Drs will do anything they like if they aren't told that they definitely CAN'T and the only time they get reprimanded is when they kill someone.
                    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

                    Comment


                    • #11
                      Re: MDS problems

                      Well the Dr who gave repeat scripts for mephalan is still practising.

                      Apparently, GMC advice is only heeded by Drs if it makes life easier for them, ie one script instead of four to sign for MDS.

                      Temazepam on most repeats and pts have taken for years. Are scripts for 56 illegal?
                      johnep

                      Comment


                      • #12
                        Re: MDS problems

                        Since the post Shipman reports giving more than 28 days supply of a CD is unethical and should be discouraged!

                        Like they give a toss about that!
                        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

                        Comment


                        • #13
                          Re: MDS problems

                          Its just the admin burden of generating 7 day scripts and having to sign them. The problems occur with a monthly script and you are expected to re-pack, re-do MUR sheets when there is a mid-month change in medication? Who else would take legal responsibility for unlimited damages for nothing?

                          The general benefit of MDS is to everyone else but not the pharmacist as we are being used as hazard mitigation. Unwittingly pharmacists have also played a part in deskilling care in nursing homes by taking on MDS which means that the nursing home can use less qualified staff.

                          Next time you do one - time how long it takes from beginning to ready for issue. Work out the hourly rate, but do it sitting down because you are in for a shock.

                          On another point - if there are more 3 months scripts coming through get on to the PSNC about restoring the additional fee for large quantities - it went out of the tariff around 3 years ago (I think).
                          47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                          2018 AD : Modern Man : I shopped, I clicked, I collected.
                          How times change.

                          If you find you have read something that has upset or offended you an anyway please unread it at once.

                          Comment


                          • #14
                            Re: MDS problems

                            Originally posted by Linnear View Post
                            Since the post Shipman reports giving more than 28 days supply of a CD is unethical and should be discouraged!
                            Where can I find the reference for that please.

                            Jeff

                            Comment


                            • #15
                              Re: MDS problems

                              Try this:


                              New Controlled Drug prescribing rules introduced


                              Prescribers are "strongly recommended" not to write Rxs for more than 30 days.

                              This is lifted directly from the DH document.


                              Hope this helps.
                              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

                              Comment

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