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Xrayser: Pharmacists shouldn't need a shortages protocol to be heroes

How can pharmacists be heroes when they aren’t even trusted to carry out basic clinical services without reams of paperwork, asks Xrayser

Everybody loves a hero. Whether it’s real life heroes seen commemorating the 75th anniversary of the Second World War parachute landings in Arnhem, the Netherlands, or superheroes in spandex for us to Marvel at on the big screen, we can’t get enough of them. Who wouldn’t want to emulate those Super Men and Wonder Women of the silver screen and real life?

Civilians might not save people from falling aeroplanes, but maybe we could become fire fighters, police officers or paramedics. Maybe at 18 you yearned to study medicine and be saving lives like the A&E doctors on Casualty. But here we are in pharmacy. Are we heroes?

Finally our frustrations are over, because now we can all be heroes! Now we have serious shortages protocols that the Pharmaceutical Services Negotiating Committee (PSNC) and Royal Pharmaceutical Society (RPS) have hailed as an empowering new way of working for pharmacy.

This conjures up images of suffering and distraught patients desperately seeking succour at their high street chemist, crying: “Who was that white-coated hero? They appeared from nowhere, changed my fluoxetine 40mg script to two 20mg packs and then left before I could thank them!”

Yes, a new era indeed. Except, of course, it’s not. Thirty years ago, in the days when all scripts were hand-written, the instruction “fluoxetine 40mg daily 1/12” was interpreted with whatever best suited the patient, while medicines management pharmacists have been instructing GPs on drug switches for the last 15 years or more.

Yet in this age of miracles, when NHS England is proclaiming the success of ‘clinical’ pharmacists, we community pharmacists need a five-page protocol to swap two 20mg capsules for a 40mg one.

Why does it take so long to permit pharmacists to carry out even the most basic of clinical tasks? Take the flu jabs for example – probably one of the safest clinical procedures, so much so that they are administered in GP practices by healthcare assistants, yet we have to undergo endless training and accreditation and complete reams of paperwork. This includes, most insultingly of all, a feedback form – presumably to ensure we’ve not jabbed the patient in the eye.

Meanwhile, I am not considered qualified to sell or supply the very prescription drugs that I handle daily and which many of us who have qualified as independent prescribers are issuing regularly. If PSNC and the RPS really want to hail a new era for pharmacy, they should negotiate a service that treats us like true healthcare professionals – or at least as grown-ups.

Nonetheless, there’s one true hero pharmacist, Raj Modi, who braved both the threatened flood of Whaley Bridge in August by hand delivering urgent medicines to patients, and the flood of nuisance calls by broadcasting his personal phone number. That’s the sort of practical healthcare needed. He didn’t require a five-page severe situation protocol to tell him to do the right thing.

A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser

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