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Is community pharmacy the cesspit of healthcare!

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  • Is community pharmacy the cesspit of healthcare!

    Are we at the bottom of the health foodchain? We are often victims of offloading by other healthcare teams, we even do the nurses jobs of vaccinations! We already deal with the sometimes difficult interaction of daily consumption clients, we now offer motivational and behavioural interviewing, I am seeing some patients are coming to us with acute cases of a mental crisis.
    Last edited by Primrose; 2nd, November 2018, 02:38 PM.

  • #2
    in short, yes

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    • #3
      Originally posted by coulsdon View Post
      in short, yes
      I like your honesty, you did not polish your answer!

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      • #4
        Encouraged by the DOH trying to reduce pressure on GPs. Just another straw on the back of the pharmacist donkey. NHS leaflets say "you can see your pharmacist anytime"
        johnep

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        • #5
          Originally posted by johnep View Post
          Encouraged by the DOH trying to reduce pressure on GPs. Just another straw on the back of the pharmacist donkey. NHS leaflets say "you can see your pharmacist anytime"
          johnep
          well put, The Pharmacist donkey is your port of call anytime without an appointment! Really annoys me , somwtimes I have about 6 to 8.people wanting immediate access to my hardworking self for their broken bones and dental absessess! One waiting cuatomer was having a miscarriage!

          Did the leaflet say Pharmacy is the new A&E?

          Last edited by Primrose; 2nd, November 2018, 05:58 PM.

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          • #6
            And to cap it all after a gruelling career dispensing millions of NHS prescriptions many pharmacists get no NHS or company pension. The doctors on the other hand are encouraged to retire at 55 and I am informed they get a £250,000 lump sum and £55,000/year pension. While the doctors have a much enriched retirement pharmacists on the other hand could end up destitute if they had to stop work at such a tender age. Many specialist doctors, although not all, have only a few patients to see daily. Pharmacists are used by everyone but not greatly valued.

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            • mcitr
              mcitr commented
              Editing a comment
              Could be worse eh, you could be pharmacy support staff!

          • #7
            Depends what you see as the demarcation between health and social care. If you classify them as different things then yes community pharmacy, the retail end is the cesspit of healthcare. If you don't make the distinction, there are some unpleasantly very stretched services and workers in social care. Grimly so.

            On the mental health side of this, what's the issue there? Unfortunately primary care absolutely sucks for mental health. If you've got a really good partner or family that has a good relationship with their GP and supports people getting in there or the more middle class that can elbow their way into the sparse talking therapy services it sort of works. For everyone else it absolutely sucks, GPs are terrible at this stuff. It absolutely makes sense that someone with mental health problems would rather go to a pharmacy than a doctors with a dragon on reception and stupid frigging lottery telephone system to book appointments.

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            • #8
              Originally posted by Primrose View Post

              well put, The Pharmacist donkey is your port of call anytime without an appointment! Really annoys me , somwtimes I have about 6 to 8.people wanting immediate access to my hardworking self for their broken bones and dental absessess! One waiting customer was having a miscarriage!

              Did the leaflet say Pharmacy is the new A&E?
              No disrespect intended, but I suspect that's probably because you and/or some of your colleagues are very good at your (and other people's!) job and it's repeating itself. I'd call it business, but you're probably not getting paid a penny for it.

              Had many a conversation in pharmacy with different managers about 'how far should we go' and 'eh?'. I've had quite a few high profile examples of really useful help not really appropriate for pharmacy and then a patient has come back a week later when it's really busy and we've said the 'sorry we have to prioritise NHS patients' and the patients are WTF you helped me before and yes sir, I remember, but we're a pharmacy not an A&E/minor injuries/etc, we can try and help in 5 minutes. Wah!

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              • #9
                I really think the PDA should clarify when and what is within a Pharmacist expertise, for example ,I have seen my colleague counsel a PND lady who looked to me as not just sad but paranoid and disturbed (body language,behaviour,repetitive requests,fabricating illnesses etc I advised him to refer as her family could very easily blame him if his so called counselling failed.

                In my opinion a specialist doctor should see her, and when she came asking for my colleague and he was off I was then called but correctly signposted her to her GP for appropriate referral ,she then made a loud sarcastic remark about how useless this is and that she wanted a consultation like the other pharmacist does !!!!!!

                I am a pharmacist not a consultant psychiatrist!
                We are picking up the slack for a failing NHS and getting no rewards for it just blame and disrespect.

                Disappointing but not surprising!

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                • #10
                  Should be a counsellor available via her GP surgery.
                  johnep

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                  • #11
                    Originally posted by johnep View Post
                    Should be a counsellor available via her GP surgery.
                    johnep
                    Yes but she can not access a counsellor anytime she wants like she does now with a pharmacist. This type of person is so agitated a weeks wait is a nightmare to them.

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                    • #12
                      Johnep, only a minority of GP surgeries have counsellors in the sense you mean. Your view is misinformed.

                      The stuff gets a bit muddied as there are counsellors and pwps that tour different surgeries, artificially boosting the numbers on paper. If there wasn't a problem then none of this social prescribing would exist and CSWs wouldn't exist either! Mental health funding is insanely underfunded and done on the cheap. The differences in primary care mental health funding vary by a factor of three.

                      In terms of PND, someone can tell me if this is wrong, but I believe that there are teams in CCGs to deal with this, the problem is if it goes beyond 2 years it isn't regarded as PND and they wave bye bye. A city of half to a million people have 2-6 midwives actively trained in this, but hugely overstretched and many are unaware of the services offered. The perinatal stuff is getting better but similarly overstretched.

                      PND is vastly underestimated by people, I believe even today it goes vastly undereported. Where I volunteer it's a constant passing the buck in mental health onto others. I get queries from other charities or the NHS trying to pass people on assuming that other organisations are fully kitted out with therapists and flashy offices.

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                      • #13
                        Many, many, many years ago when I was only a year or so qualified a women came into my pharmacy and asked for ‘something for her rash’. Fair enough; what had she tried, who else had she asked. She reeled off a list, including dermatologists (aka ‘the hospital’). Nothing had worked and it was irritating. I replied that I’d have to have a good think about this and could she come back later. No she replied, she had a train to catch and she thought I’d give her something there and then!
                        Went off in a huff!!!

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                        • #14
                          Originally posted by Merlyn View Post
                          Many, many, many years ago when I was only a year or so qualified a women came into my pharmacy and asked for ‘something for her rash’. Fair enough; what had she tried, who else had she asked. She reeled off a list, including dermatologists (aka ‘the hospital’). Nothing had worked and it was irritating. I replied that I’d have to have a good think about this and could she come back later. No she replied, she had a train to catch and she thought I’d give her something there and then!
                          Went off in a huff!!!
                          The problem community Pharmacists are facing now is the extremely high and unrealistic expectations from custoners and if they don't get this miracle cure THEY WILL COMPLAIN ABOUT YOU! I have seen it many times, I always give a disclaimer before the consultation that I am not a dermatologist and can not provide a cure just symptom control. I always emphasise I am not a doctor and therefore will refer if beyond my ability. They get angry but can't complain.

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                          • #15
                            Originally posted by Primrose View Post

                            The problem community Pharmacists are facing now is the extremely high and unrealistic expectations from custoners and if they don't get this miracle cure THEY WILL COMPLAIN ABOUT YOU! I have seen it many times, I always give a disclaimer before the consultation that I am not a dermatologist and can not provide a cure just symptom control. I always emphasise I am not a doctor and therefore will refer if beyond my ability. They get angry but can't complain.
                            I think Primrose has touched on an important point; my episode was when i was an owner-manager; there was no-one to whom the ‘patient’ could complain. I get the impression, rightly or wrongly, that big chains will ALWAYS accept the complainants word as gospel, without properly investigating.
                            I must say though that in 30 years of community pharmacy that woman stuck out as unusual in expecting miracles on the spot.

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