NPSA Leaflet

[Linnear]

I know that this is from The Sun but it is scarily close to my remarks whenthe EPB was asked to consult on these documents!

Health | NHS | 'Patronising' guide to labels | The Sun |HomePage|News

Seemed an expensive document to say something which my 6 year old daughter could have worked out after standing in a dispensary for two hours.

[Pharmanaut]

Re: NPSA Leaflet

I know that this is from The Sun but it is scarily close to my remarks whenthe EPB was asked to consult on these documents!

Health | NHS | 'Patronising' guide to labels | The Sun |HomePage|News

Seemed an expensive document to say something which my 6 year old daughter could have worked out after standing in a dispensary for two hours.

A lot of the reading in this document is a must for all students to read during their vacation from passing 'A' level before going up to Uni. Howeve,r we should not be as dismissive and at least read it for ourselves.

There are two nuggets in my view.
1. Do not dispense from labels. Always dispense from the Prescription. This is OK for now, but what happens when there is no prescription? EPSR2?
2. When a patient collects their medication the final final check is to unpack the bag and go through each item and dose as you pack it in the bag.


I'd like to get a discussion going on point 2, but please read it for yourself first - I may have interepreted it incorrectly.

As for how to sit a computer - who sits in a pharmacy?
Additionally the way some computer systems are arranged it is neither comfortable to use them standing up or sitting down. If this was an office environment it would not be tolerated.

[Jeff]

Re: NPSA Leaflet

2. When a patient collects their medication the final final check is to unpack the bag and go through each item and dose as you pack it in the bag.


I'd like to get a discussion going on point 2, but please read it for yourself first - I may have interepreted it incorrectly.

Discussed it at work today - questions about confidentiality - everything unpacked at the counter - what if it's not the patient who is collecting?

Jeff

[the old merlin]

Re: NPSA Leaflet

Agree with Jeff. And AT THE COUNTER???

Maybe in a consulting room!

Anyone else remember the Monty Python sketch where the pharmacist came and said "All right, whose got the pox?"

[admin]

Re: NPSA Leaflet

Agree with Jeff. And AT THE COUNTER???

Maybe in a consulting room!

Anyone else remember the Monty Python sketch where the pharmacist came and said "All right, whose got the pox?"

I used to have this discussion at a couple of BTC branches I worked at all the time. Their policy was (maybe still is - I don't go there now) to dispense everything at a counter that had no privacy whatsoever, with all the drugs on view of the waiting public.

I asked the obvious - what about confidentiality? Their policy was to dispense Viagra in the back. I thought fine, but I'm not sure I would want everyone in the queue knowing if I was taking say Prozac, or I had angina, diabetes etc etc etc

Having your prescription done in the back, and passed out to you already in a bag obviously raised some eyebrows too - what's he getting that's so secret?????

Then of course comes the problem if there is a mistake - which there frequently was at that particular branch. I used to say to the dispenser "would you have another look at that for me please" but I'm sure the patient knew it was an error - why was his/her script going into the back again?

This never happened at that branch, but what do you do if the script is a forgery?

Just my initial houghts......I hated working this way!

[Pharmanaut]

Re: NPSA Leaflet

Discussed it at work today - questions about confidentiality - everything unpacked at the counter - what if it's not the patient who is collecting?

Jeff

Good - have got the debate going at last.

[Titch]

Re: NPSA Leaflet

My understanding is all Alliance stores will be converted to open dispensing format when rebranded to Boots.

Now is the time to raise concerns....

[ymdawd]

Re: NPSA Leaflet

My understanding is all Alliance stores will be converted to open dispensing format when rebranded to Boots.

Now is the time to raise concerns....

Now that scares the hell out of me. Not all of us want to be rebranded Boots.

ymdawd

[Titch]

Re: NPSA Leaflet

Don't think there is any say to be had from what I hear from friends who work for one or the other.

[Robatcymraeg]

Re: NPSA Leaflet

Now that scares the hell out of me. Not all of us want to be rebranded Boots.

ymdawd

It's been suggested elsewhere that a formal complaint shoul dbe made to Stat Com about the lack of confidentiality in completely open dispensaries.

What does anyone think?

[lamzee]

Re: NPSA Leaflet

yes--someone please put a stop to open plan dispensaries! They make me want to retire (very) early!!!

[Pharmanaut]

Re: NPSA Leaflet

It's been suggested elsewhere that a formal complaint shoul dbe made to Stat Com about the lack of confidentiality in completely open dispensaries.

What does anyone think?

A complaint from a patient would carry more weight.

[SolomonQ]

Re: NPSA Leaflet

imagine with an open plan setting:

the pharmacist is busy shifting the workload in the dispensary, many repeat and waiting prescriptions to dispense, nomad/dossette trays to check, queries to make, CD entry to make etc etc... a patient come into the pharmacy and wants to talk to the pharmacist about a chesty cough. normally in such a situation the assistant cud say s/hes busy, but in open plan the patient can see the pharmacist in the dispensary and even though s/he seems to be workin the patient expects the pharmacist to stop workin and come and speak to the patient. Actually in this situation the patient wudnt even ask the assistant and kinda shout out for the pharmacist trying to get eye contact with them, commiting them to talking to the patient. (after eye contact, blanking wudnt really be a polite gesture from the pharmacist).

other issues raused:

-lack of privacy in such settings (e.g. if the pharmacist or other staff are less than pleased they cannot express their disgust because they are in full view of patients, these situations are needed when e.g. the doctor fails to comply to a decent request)

-further degradation of the reputation of pharmacists (people tend to put low value on things they can get to easily e.g. when patients go to see the doctor they wait outside a room with closed door, they might be made to wait longer than expected but dare not complain because the doctor might not treat them properly, thats why doctors are valued but with pharmacists if made to wait for longer than a few mins they can jus go to another pharmacy next time or ask for their RX back)

-patient brings in Rx and wants to wait, Rx passed to dispensary, although there is no one else waiting in the pharmacy, no one is able to attend to it straight away because of other ongoing activities. dispenser cud be in the middle of a large repeat script, and the pharmacist cud b checking a dossette box, what wud the patient's reaction be to this in an open plan setting.

-etc etc...

[Jeff]

Re: NPSA Leaflet

imagine with an open plan setting:

the pharmacist is busy shifting the workload in the dispensary, many repeat and waiting prescriptions to dispense, nomad/dossette trays to check, queries to make, CD entry to make etc etc... a patient come into the pharmacy and wants to talk to the pharmacist about a chesty cough. normally in such a situation the assistant cud say s/hes busy, but in open plan the patient can see the pharmacist in the dispensary and even though s/he seems to be workin the patient expects the pharmacist to stop workin and come and speak to the patient. Actually in this situation the patient wudnt even ask the assistant and kinda shout out for the pharmacist trying to get eye contact with them, commiting them to talking to the patient. (after eye contact, blanking wudnt really be a polite gesture from the pharmacist).

So an accuracy check is a higher priority than talking to a patient?
Suitably trained technicians can do the accuracy check - the clinical check and ability to communicate with patents is our strength.

-lack of privacy in such settings (e.g. if the pharmacist or other staff are less than pleased they cannot express their disgust because they are in full view of patients, these situations are needed when e.g. the doctor fails to comply to a decent request)

It's called self control - and consider using a cordless phone in private area.

-further degradation of the reputation of pharmacists (people tend to put low value on things they can get to easily e.g. when patients go to see the doctor they wait outside a room with closed door, they might be made to wait longer than expected but dare not complain because the doctor might not treat them properly, thats why doctors are valued but with pharmacists if made to wait for longer than a few mins they can jus go to another pharmacy next time or ask for their RX back)

And you are a part of a positive feedback loop that implies that the prescription which needs your attention is more important than a patient consultation that can wait - preferably out of sight.

patient brings in Rx and wants to wait, Rx passed to dispensary, although there is no one else waiting in the pharmacy, no one is able to attend to it straight away because of other ongoing activities. dispenser cud be in the middle of a large repeat script, and the pharmacist cud b checking a dossette box, what wud the patient's reaction be to this in an open plan setting.

It gives you the opportunity to explain to the patient - while holding up a yard of labels - that you are in the middle of a long script and that being a mere male are unable to multitask safely - so her prescription will unfortunately be a few minutes.

Are you really so scared of talking to patients? It's talking to them that creates loyalty.

Jeff - who prefers patients to prescriptions.

[SolomonQ]

Re: NPSA Leaflet

I hope I do assume rightly that most pharmacies dont have the dispensary support that they should have, as Jeff assumes,

Relating to the different points and scenarios:

-I think Jeff underestimates workload of most pharmacists, checkign is an exercise the pharmacist needs to perform most of the time aswell as the clinical check, not all dispensarys are laden with ACTs.

-about the privacy, so Jeff suggest when the fitters for the open plan come we should also ask them to install a cordless phone for us, so we can talk in private, i wonder where this privacy would be achieved as most pharmacies are not as big as he assumes

-about self-control, people get agitated and distress on purpose dont they and they can see it coming so they can exercise self control, atleast Jeff thinks so, the rest of us are human

- about being part of the so called positive feedback loop, the pateitn sees you putting stickers on a pack of tablets, im not sure how much experience Jeff has had with how patients treat the packaging and especially the labelling on the medicines, just to make it simple they dont really think they're important and everyone thinks about themselves anyway

- about the explaining, well how many times are you going to waste (literally) time by telling patients this. nothing to do with being scared to talk to people. Im still at the stage in my career where im eager to talk to the patient.

I prefer patients to prescriptions too but you should never forget a pharmacist's main link to a patient is through their prescription (atleast in the community setting).

If the pharmacist spends his time talking to such patients, what happens to the patient whose prescription needs to be dispensed. and lets not forget what pharmacy contractors employ pharmacists for, to make profits for them, talking to patients doesnt make them profits (atleast in the short-term), diespensing prescriptions does.