Christmas is over, we're into January, and the naff presents, New Year resolutions and hangovers are but a distant memory. But I'm left with a bitter taste - not from the overcooked sprouts but advice letters from the NPA and the Pharmaceutical Society, touching on legal aspects of daily practice. Clear and unambiguous, they explain aspects of pharmacy practice without the usual "grey area" characteristic of missives from the old RPSGB. But last month the grey was replaced by my seeing red.
They concerned repeat dispensing and controlled drug instalment scripts - the latter being an area where clarity is most definitely required. Most prescribers experience some sort of brain meltdown when it comes to wording FP10MDA scripts, unable to add up 14 days of 35ml, forgetting to initial alterations or just not sign at all, and not grasping the concept of any pharmacy not open 24/7 over public holidays.
Well I'm OK with that. It's understood by all in primary care that while GPs can heal the sick - and are clever enough to be rich - their strengths don't always extend to the minutiae of detail, and so when prescribing flucloxacillin tablets or other non-existent form, or writing doses in abbreviated Latin slang our job is to interpret this for the benefit of the patient. After all - we are healthcare professionals.
And yet it seems that when it comes to pedantry, the wording of the medicines acts over-rides any professional sense or judgement we would be expected to exhibit for the benefit of patient care. For example, if - god only know why - a prescriber sets a dispensing interval on "Repeat Dispensing" scripts, and a patient needed the next RA dispensed even one day before, the GP has to write a new FP10.
OK - stupid as it may be, maybe that is fair enough since the prescriber's written intentions are clear. 56 days - no sooner. Not even if it meant the next dispensing was Christmas day and we're shut for the weekend? No doctor, you have to write a replacement script.
But then how about the next advice letter regarding CD instalment scripts. "Supply Sunday's dose on Saturday in advance" - that makes the prescriber's intentions pretty clear, and yet this and several other blindingly unambiguous phrases are deemed illegal. So where it matters most, because of the inherent hazards of these drugs, it is a Home Office pen-pusher who decides safety - not a trained healthcare professional? How pathetic. And how pathetic that we have allowed this to continue!
The laws around drugs are supposed to protect the public, but these two examples show that to be nonsense. If our representatives cannot address such jobsworth legal interpretation it's no wonder we can't get dispensing errors decriminalised, and we will continue to struggle to get a seat at the clinical commissioning group table as such enforced pedantry makes us look stupid and pathetic in the eyes of both doctors and patients.