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REVEALED: 4 in 10 CCGs to scrap pharmacy repeat dispensing

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Almost four in 10 clinical commissioning groups (CCGs) in England plan to stop pharmacies from ordering repeat prescriptions on behalf of patients, a C+D investigation has revealed.

The findings from C+D’s in-depth investigation – drawn from data from 113 CCGs released under the Freedom of Information Act – reveal that 38% have, or are planning, schemes to stop community pharmacies from ordering repeats.

The investigation also showed that 42% of CCGs either have, or are considering, schemes to instruct patients to order repeat prescriptions directly from their GP.

Many of the CCGs that are rolling out these schemes are facing significant financial deficits – and C+D’s investigation found that 41 CCGs predict they are currently losing a total of £74.7 million every year as a result of medicines wastage. In an attempt to address these losses, CCGs estimate they could save an average of £1.4m each by implementing their repeat dispensing policies.

The growth of these schemes comes after C+D highlighted in August that three CCGs in the north west of England and East Anglia are implementing schemes to block pharmacies from reordering prescriptions. They estimated the move would generate total savings of around £10m a year.

"Cost more than they save?"

But David Taylor, emeritus professor of pharmaceutical policy at University College London who has researched the economics of medicines waste, told C+D he doubts whether similar savings are achievable across the country. If the CCGs’ schemes prevent patients getting their medicine, they will ultimately “cost more than [they] save”, he stressed.

Behind the scenes of C+D's data-driven investigation

What did C+D ask?

We asked all 209 clinical commissioning groups (CCGs) in England for details of repeat dispensing schemes they have or plan to implement, and how much they plan to save through these.

How did we do it?

We used the Freedom of Information (FOI) Act, which CCGs are subject to as public sector organisations, to obtain details of their accounts and medicines management plans.

How many responded?

Some 113 CCGs responded to our FOI request: 47 provided details of their schemes, 41 gave estimates of medicines waste costs, and 19 gave estimates of potential savings.

What did we find?

Nearly four in 10 CCGs in England are stopping community pharmacies from ordering repeat prescriptions, and estimate they could each save an average of £1.4m by doing so. 

Commenting on C+D’s findings, Pharmacy Voice board member Hiten Patel predicted the CCGs' schemes will not benefit patients.

“You’re going to have tens of thousands of patients depending on surgeries, and problems might arise with prescriptions being signed. It also means that more contact occurs at the surgery, when what we should have [is] patients contacting the pharmacy,” Mr Patel said.

Nick Hunter, chief officer for Nottinghamshire, Doncaster and Rotherham local pharmaceutical committees, said previous schemes to stop repeat dispensing in his area had been unsuccessful.

“My experience has been when CCGs start looking into it, they realise it’s far more complicated and it becomes convenient to blame pharmacies and make them scapegoats,” he told C+D.

“There’s so much pressure on CCGs to be seen to be doing something because of the financial situation. [But] if the government really thought this was a problem, they would have done it before now at a national level. It’s a knee jerk reaction that’s creating more work rather than solving the problem.”

Read the full C+D investigation and see a map of the areas where the schemes are being rolled out here

29 Comments
Question: 
Do you have a repeat dispensing scheme running in your area?

John Ashworth, Community pharmacist

So far its working great. We can still order for vulnerable patients the rest are having to do it themselves. Monday mornings without the phone ringing every two minutes is fantastic.

amelia brown, Community pharmacist

Go on http://www.petmd.com
 

Gerry Diamond, Primary care pharmacist

There are fraudulent imbeciles and incompetent pharmacist that deliberately and unknowingly fail to manage repeat dispensing prescriptions. I had a run in with one such after a patient complained but it doesn't help when most of the pharmacy staff are lazy and incompetent.

Jupo Patel, Production & Technical

I use to work in the Edgware road(approaching Marble Arch) area of London. The pharmacists there were very interesting characters to say the least..........

Yo Palumeri, Community pharmacist

give 6 months AND  1000's of phone calls to surgery by patients

T. Pharm., Community pharmacist

Misleading headline

N O, Pharmaceutical Adviser

"""pharmacy repeat dispensing"""

It is NOT Repeat Dispensing but Repeat Ordering through Pharmacies. Repeat Dispensing is an essential service for which all pharmacies get paid every month.

Jignesh Patel, Superintendent Pharmacist

Not anymore!!! Payment has been scraped as part of the pharmacy cuts

PARESH shah, Community pharmacist

I hope all internet pharmacies are also stopped from ordering repeats and not just bricks and mortar ones. This will bring business back to local pharmacies once suregeries have to provide urgent repeats. 

S Patel, Superintendent Pharmacist

....

Jonny Johal, Pharmacy Area manager/ Operations Manager

Rolling back to the seventies? Close Amazon so that we can make Debenhams more profitable? If no pharmacists over order we wouldn't be in this position. Internet pharmacies' orders are 100% auditable.

S Patel, Superintendent Pharmacist

....

Jonny Johal, Pharmacy Area manager/ Operations Manager

By quantifying the amount of money saved, the CCGs will be able to discover the scale of over-ordering by pharmacists, I welcome this move. Do people think, by drilling into the data, they can identify which pharmacists are responsible and take appropriate action?

Lilian Anekwe, Editorial

It's a good question. There may be some CCGs that are developing their own mechanisms for identfying wastage at particular pharmacies. To highlight a potential example, the response from NHS Hambleton, Richmondshire and Whitby noted that "where there are examples of poor application, then the CCG and [GP] practices will consider stopping in individual pharmacies."

Lilian Anekwe,

Deputy editor

Shaun Steren, Pharmaceutical Adviser

Until they publish the trial we will not be able to elucidate the mechanism by which the 'savings' are being made. Have they simply stopped current wasteful mechanisms of ordering or are have they introduced a wholly new mechanism which is unique to GP ordering? How do they calculate the savings and what is the accuracy? 

There has been many bold claims for savings and reproducibility, it will be interesting to see if they can provide the proof. At the moment their control group is a financially interested sector whose position (as per usual) is based on fallacious argument. 

John Urwin, Community pharmacist

Only if a surgery deals with only one pharmacy. This whole exercise is designed to counter the dubious practice of "managed repeats". Surgeries and CCGs already have a pretty good idea of which pharmacies are involved.

Sue Per, Locum pharmacist

Why not send the lead to the fraud squad!

Sarah Smythe, Information Technology

I 've been informed someone already has and that when no CCG's were prohibiting this. So looks like someone is taking an investigative look at this 

Paul Miyagi, Information Technology

Such good news, Most customers don't like it and are sceptical of it , staff don't like it as its a pain to operate, Pharmacists get it in the neck when it goes wrong. surgeries do not welcome it either ,so it seems the only people "lovin it" are AM's etc of the multiples.  Oh dear, profits down again .

David Holdsworth, Community pharmacist

How will the surgery know if the repeat order slip comes from the patient or the pharmacy ?

Paul Knapton, Community pharmacist

From the headline I thought this was about Repeat Dispensing (which is wonderful), rather than Pharmacy-managed repeat rescriptions.

John Dow, Advertising

Best News since "The Guardian " exposure on "Cash Cow" MUR's . Oh how those multiples coffers must be hurting. After the 4/10 CCG cash savings have been published , more CCG's will prohibit this , thats a certainty.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Ah, why just multiples, don't you think independent's may be doing the same?

Shaun Steren, Pharmaceutical Adviser

They ought to publish the trial evidence right away. The data, methodology and claims for reproducibility need to be scrutinised. Meanwhile anecodote, gut instinct,  magic, the supernatural, prophecy and mythology lead the debate. 

Barry Pharmacist, Community pharmacist

Once again the CCGs totally miss the point. Pharmacy staff will rejoice at not having to do this. Let us see how the surgeries cope. Pharmacies assist GPs more than they hinder and the sooner CCGs understand that the better they will be at helping the NHS avoid a train crash

Nat Mitchell, Community pharmacist

And I'll be referring all phone calls/questions about missing items to the surgery.  Might even get an automated message done.

Liz Jones,

Fantastic. Hope more do it. Its this sort of nonsense that causes stress for pharmacists and makes massive profits for multiples. I found that most patients did not want to sign up for it anyway but were pressured by staff, who were pressured by Bosses. Things are improving hahaha

Valentine Trodd, Community pharmacist

Hurrah! Bring it on. I can't wait! They might want to employ a few more dolly birds to answer the phones though - I can't get through as it is!

Kevin Western, Community pharmacist

Go for it - It cuts down my phone answering and The surgeries can  no longer say the Pharmacy didnt put your order through, plus having had the 3rd repeat of a special for the same patient in a fortnight, something tells me we may be better off....

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