Department of Health defends changes to methadone payments

I think that this is a serious blow to contractors and to the quality of services offered to substance misusers. Community pharmacists are coming under increasing pressure with managing CDs, substance misuse services in terms of the documentation, supervision, social, behavioural and regulatory bodies e.g. LIN to be be more proactive in communicating soft inyelligence back to drug teams, dealing with eratic adherence dilemmas out of hours with no support in place. The fees for MDA dispensing should be increased and not cut to keep up with pharmacist commitment to deliver community services that the NHS would find difficult to run effectively and efficiently if run by an in house NHS provider.
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as usual its a question of cost cutting dressed up by simplification. Unless pharmacists stop providing services its only going to get worse. in the old days we didnt supply any methadone and may just stop providing the service again.

I'm astonished that PSNC has agreed to this. It will cost my pharmacy a very significant amount, and we only gave daily doses if they were specifically ordered.

It's actually worse because some of our clients consume part of the dose and take the rest away, so we used to get two fees to reflect two dispensing actions.

Why does anyone think supplying in 7 separate bottles for a weekly script was correct. It will not stop those users from taking more than a single daily dose just because they are packed in separate bottles.

Those contractors crying now with the change, blatantly exploited a giant loophole which was never intended to be there.

If the doctor thinks the patient needs daily amounts to take away then the patient should have to have daily amounts supplied daily, not give a weekly script asking for it to be dispensed on one day but in seven separate doses.

This may be a bit cheeky, but how many of the contractors taking advantage of the loophole are owned by GPs? Or is that a whole other can of worms?

This is a disaster - many contractors will not fully realise the impact until they receive their October NHS payment.

PSNC should be ashamed of themselves for agreeing this. It's not simpler, it's no more transparent, it offers pharmacist absolutely no extra professional discretion and it fails to reward the extra work involved.

How can we stop it? Is legal action a possibility?

From the PSNC constitution. Functions of the PSNC...

3.1 to secure for Chemists the best possible contractual terms and remuneration in
respect of National Health Service pharmaceutical services and Directed services
provided by them.

they're doing their job then??

We can't strike. We are too fragmented as a profession unlike so many other professions. Where is the single union that we are all unanimously a part of. It's hilarious but our Code of Ethics demands that we do not strike, because harm would come to patients. It would be seen as putting personal monetary gain over the health and wellbeing of a patient.

In fact out of all healthcare professions pharmacy would be the last to strike - we are the expected to lay our personal wellbeing on the line for that of the patients, and to do so for free. If we charge for doing this we're accused of being money-grubbers. What a claustrophobic deadlock we're in. It's like being stuck on the ropes with a towering George Foreman laying into you with haymakers, and all you want is reprieve but the referee is refusing to stop the fight. You just have to keep eating those haymakers until you are outcold - or bankrupt.

And on another point, if most of the profession went on strike, there would be a large group of pharmacists who would disagree with it and refuse to go along, as well as opportunists who would use it to secure extra prescriptions/patients. Can we really turn an ill child away or a terminally ill patient who needs morphine? We are too compassionate for our own good, a fact which the paymaster knows well and is abusing daily. A bit of ruthlessness would probably get us some results.

Have to disagree in part... Having daily doses in individual bottles is the difference for some patients between "accidentally" taking more on one day out of a stock bottle or ending up mis- dosing themselves because they can't be bothered to measure accurately... Are we not in the business of helping them to help themselves by keeping the opportunities to give in to temptation to a minimum!?