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GP view: Are the fluoxetine powers a victory for common sense?

The fluoxetine shortage powers are a step in the right direction for pharmacists, but GPs’ time is still being wasted unnecessarily, says Dr Toni Hazell

Apologies in advance, you’re probably sick of me wittering on about drug shortages.

In May, I wrote about how frustrating it is that pharmacists, highly trained professionals, aren’t allowed to dispense two 250mg packets of naproxen if the 500mg one isn't available. It’s an insulting waste of their time and mine to force a pharmacist to ring me for permission to make this change. So, I was interested to see that a 'shortage protocol' dealing with exactly this issue was launched this month.

There is an issue with the supply of fluoxetine 10mg, 30mg and 40mg strengths, but plenty of the 20mg tablets and liquid form are in stock. Pharmacists are now officially allowed to swap the different strength tablets (or change to a liquid) without the permission of a GP, and with the patient’s consent.  

Hallelujah! A victory for common sense – or so it seems. Maybe, just maybe, the Department of Health and Social Care (DH) has actually worked out what is going on at the grassroots level of the NHS. Maybe it has realised that with European doctors living in the UK increasingly considering leaving due to their treatment over Brexit, practices closing temporarily because of a lack of doctors, and GPs officially being labelled an occupation with a shortage, our time is too valuable to waste on unnecessary phone calls when we should be seeing patients.

Sorry, a moment of madness there. Of course the DH hasn’t realised – that would require it to face up to its own failings and impossible promises, to acknowledge that GP numbers are falling even as it promises us 5,000 more.

Clearly, the DH has been working hard to find another way to waste our time. It has suggested that GPs pro-actively contact patients taking fluoxetine to find out what supplies they have at home. A large practice might have several hundred patients taking it. Even at just a minute or two per call we would be looking at one or two days spent solidly calling patients, while the work that we should be doing piles up.

Oh well. Let’s look on the bright side – activation of the first shortage protocol is a milestone. If it works well and leads to a situation where pharmacists can make these common-sense swaps under their own authority on a long-term basis, then at least something good will have come out of all the hassle of recent medicines shortages.

Toni Hazell is a GP based in a practice in London

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