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Government eyes overhaul of who can prescribe and how to dispense

DH: Professions to benefit from extended prescribing powers will be subject to consultation
DH: Professions to benefit from extended prescribing powers will be subject to consultation

The government wants power to expand the range of health professionals who can prescribe low-risk medicines, as well as develop “innovative ways of dispensing”.

One of the main elements of a proposed Medicines and Medical Devices Bill – referred to in the Queen’s Speech yesterday (October 14) and expanded on in a government briefing document – is: “Enabling the government to increase the range of professions able to prescribe low-risk medicines to make the most effective use of the NHS workforce, as well as developing more innovative ways of dispensing medicines, where recommended by scientific experts.”

The Department of Health and Social Care (DH) told C+D that the professions who will benefit from this extension of prescribing powers, and which low-risk medicines will be included, will be subject to public consultations.

However, it pointed to pharmacists delivering flu vaccines under patient group directions as an example of how “similar powers have been used in the past”.

Expanding prescribing powers “will ensure patients are able to get medicines from the most appropriate healthcare professional for their situation quickly and pressure is reduced on the wider NHS workforce”.

“This includes exemptions that allow some professionals to administer specific medicines for immediate necessary treatment,” said the DH, which pointed to paramedics administering pain relief in emergencies as another example.

All further details of the proposed powers will be informed by “public consultations, drawing on the expertise of clinicians and medical experts”, it told C+D. More information will be “released in due course”.

Another element of the bill would be “ensuring patient safety by implementing a scheme to combat counterfeit medicines entering supply chains and a registration scheme for online sellers”, the DH said in the briefing document.

47 Comments
Question: 
Would you like prescribing powers to be extended?

A LOCUM, Community pharmacist

The time has come when all retail pharmacists should become prescribers , i understand we won't get prescrition pads , but we could  do private scripts as they can be so cheap or even do more pgd's via pharmaoutcomes like what we do for EHC, Flu , we'll save the NHS a fortune.Courses should be relevent to retail pharmacy and user friendly to us retail lot as we don't have a lot of spare time. 

Former Cist, Pharmaceutical Adviser

I genuinely don't believe there will be any enthusiasm or support for this from anywhere apart from community pharmacists. The proposed future prescribing role for pharmacists, like the clinical role, has been awarded to the practice pharmacists. The GPs I am in contact with all tell me that the efficient supply function that community pharmacy was once respected for has fallen apart and communication between pharmacies and practices is non-existent. Is it really the case that community pharmacy is totally blameless for the stock shortage problems? Do all pharmacies regularly communicate to GPs comprehensive details of what is out of stock, for how long and what alternatives are available? Practices are all developing medication review programmes to include all patients. How often do pharmacies contact GPs to inform his process? Concordance issues? Side effects? Other patient medication issues? Think about it, how would community pharmacy prescribing work in isolation from general practice? There is a role for you if you can efficiently manage the supply and communication function. But if community pharmacy goes in the wrong direction I fear for your future.

Lucky Ex-Locum, Superintendent Pharmacist

Pray advise me Mr Adviser - where does the time come from for all of this lovely fluffiness you are proposing? At the moment, pharmacists are still largely tied to the checking bench (except for those 'clinical' and 'practice' pharmacists that couldn't hack it) because prescribing (and hence dispensing) volume is only going one way with a growing and aging population, and I DO believe there would be enthusiasm for this from the general public. If you actually worked in a pharmacy, you would realise the number of times in a day that you have to refer someone to a GP, endure the face pulling and moaning about appointments, then see them return later with a prescription for the item you KNEW that they needed but were unable to supply because it's a POM. Even if we could only do private Rx, most people would go for it because the time and hassle saved is priceless and let's face it, most drugs aren't actually that expensive nowadays. I do a locum in a supermarket and their private Rx generally cost the minimum of £2 which I think virtually anyone would pay to avoid seeing their GP.

Former Cist, Pharmaceutical Adviser

As an ex-contractor who ran a very busy pharmacy I do know all about the pressures. And I can see where community pharmacy is heading with the blind leading the blind. If, as you say, you are tied to the checking bench with Rx volume only going one way, when are you going to find the time to run a clinic and carry out your consultations. Or perhaps prescribing will be conducted with the same professional commitment as is often the case with the supervised supply of OTC P meds. Prescribing by many GPs is far from perfect but are you really saying that pharmacists would make a better job of initiating meds? If you are talking about repeat meds then have you heard of repeat dispensing? If you persist with item chasing and churning, you are finished, as on-line with delivery will take over the role. IP clinical pharmacists are arriving in all GP practices to take over your clinical role. If you reject the "lovely fluffiness", seriously, why does the NHS need you?

Watto 59, Community pharmacist

£2 minumum is pathetic ... it just illustrates the value multiples put on their pharmacists and the pharmcy profession, no wonder we are where we are..

Lucky Ex-Locum, Superintendent Pharmacist

I agree with you. It's a total insult isn't it?

Marc Borson, Community pharmacist

I honestly believe that they will have pharmacy led dispensaries with the clinical check being done at any Remote site.

Greg Lawton, Community pharmacist

An analysis of the 32 regulated healthcare occupations:

 https://the-pda.org/pda-analyses-qualification-levels-of-occupations-registered-with-a-healthcare-regulator/

"Another finding was that for every occupation out of the 32, there’s a level 6 degree available for entry and registration, with one exception: Pharmacy Technicians (whose qualification is at level 3)."

"There are only 3 registered groups working with a minimum of a level 3 qualification on entry:

Dental nurses

Dental technicians

Pharmacy technicians"

Combined UCAS points value of NVQ3 and diploma on qualifying as a pharmacy technician: 64‬

‪UCAS points value of 3 A-Level B grades, the minimum for entry to the MPharm degree at all but one UK university: 120‬

‪Conclusion: both “pharmacy professionals”.‬

Former Cist, Pharmaceutical Adviser

Sadly the role of the community pharmacist is disappearing. Many of you ignored the opportunity to develop the role and instead dedicated your working lives to item chasing and with repeat ordering, item generating. The clinical role was taken over by the practice pharmacists. You are left with counting pills, sticking labels and ordering and frankly the techs can do that as well as most pharmacists as their minds are not on other things like buying and exporting. You need to find a voice, find a role, promote yourselves and demonstrate how the NHS can't manage without you.

Lucky Ex-Locum, Superintendent Pharmacist

All we need to do is go on strike for one day. It would be CARNAGE and the NHS would quickly realise just what we do (as would the general public)

Watto 59, Community pharmacist

Agreed, that is the kind of action the PSNC could and should be organising.  Unfortunatly with a large proportion of PSNC committee members representing the Company Chemists Association persuading them would be difficult in my opinion.

 

Benie I, Locum pharmacist

Carnage for a short time before multiples lobby for counter assistants to be given emergency dispnsing powers to end the 'chaos'. Don't be surprised when the emergency powers become permanent. Bye bye Pharmacist once and for all..........

Lucky Ex-Locum, Superintendent Pharmacist

And don't forget the locums who would demand a nice high hourly rate to break any strike....

Leon The Apothecary, Student

Hey, we locums respect the worth of ourselves and colleagues.

Mohammed Zeeshan, Locum pharmacist

careful.my dog might start getting prescribing powers next!!!!

Silent Observer , Manager

Careful Mohammed Zeeshan you sound threatened and bitter.

Mohammed Zeeshan, Locum pharmacist

Yes you are right!!!!!!!!! I do feel threatened and bitter,because university's take your money and promise you a career,a job,something which you can have pride in.until you actually go and do the job in a community pharmacy,then you realise you are simply a pill counter,who is simply used as a pawn for a large gready multiple to make money off.community pharmacy is the most dissatisfying job ever,but oh well I'm stuck.the worse thing is knowing your job is not even safe because some under-qualified ppl of the street who have no qualifications and who put a small time of effort in(2 years of in house,on the job studying,getting paid whilst they study) might one day because of some pen pusher take your job,because our professional body's are so gutless and spineless to not evolve our job and not give us the tools and skills to really help patients out.

 

Benie I, Locum pharmacist

You’ve learnt a painful lesson. Don’t trust anybody.

Mohammed Zeeshan, Locum pharmacist

So yes you are right,it's just life isn't it.

Sanjay Ganvir, Superintendent Pharmacist

Mohammed fyi:

NVQ 2 = four or five GCSEs at grades A*–C,

NVQ 3 = two or more A levels

 

Lucky Ex-Locum, Superintendent Pharmacist

I am putting someone through NVQ3 at the moment and have put several through both 2 and 3 in the past. There is no way on earth that 2 is worth 5 good GCSEs or 3 worth 2 A levels. NVQ2 takes 6 - 12 months, NVQ3 one year. You do the maths.

, Dispenser Manager/ Dispensing Assistant

Sanjay fyi
Shelf stackers etc in Asda can go into the pharmacy department and gain the counter assistant then NVQ2 in pharmacy services, no formal qualifications required.
They could then go on in community to in-house NVQ level 3 and become a technician (don't leave within 3 years or you will have to pay back fees)
The standard of training is incomparable with hospital training. To study through hospital you need the relevant GCSEs to embark on the course which is 2 years long and requires day release at college and rotation throughout the hospital departments.
Therefore, I feel there are 2 distinct levels of "technician "

Mohammed Zeeshan, Locum pharmacist

Just don't compare technicians to pharmacists.

It's like comparing receptionist to GPs.

call yourself what ever you want!!  

 

 

Mohammed Zeeshan, Locum pharmacist

Don't make me laugh,what are you trying to say that nvq is equivilant to 2 A-levels or that they need two A-levels to enrol.

Let's just make all technicians GPs,or even better let's make them brain surgeons,or one better jumbo jet pilots.

How all of a sudden are technicians getting so much talk about how they're gonna rule the world,when pharmacists who actually have a degree have been rubbished for years???

*This comment has been edited to comply with C+D's community principles*

 

 

 

Benie I, Locum pharmacist

becasue they’re cheaper.

Lucky Ex-Locum, Superintendent Pharmacist

And there, in a nutshell, is what's happening. Everything is ruled by money and the multiples.

Leon The Apothecary, Student

"...paramedics administering pain relief in emergencies as another example."

I find this quote particularly interesting, because only a few years ago - ambulances services were infamously quoted as being nothing but "a taxi service". Nowadays, we have Paramedic Practitioners, who are taking on advanced responsibilities, the Paramedic course becoming a BSc degree, and the role of a Paramedic expanding beyond the ambulance setting.

To me, this shows a clear example of how other allied health professionals, such as Pharmacists and Pharmacy Technicians can continue and develop into  multiskilled and dynamic professions.

Benie I, Locum pharmacist

I’m no economic guru but somebody please remind me what happens when there is an over supply of a commodity ?

Leon The Apothecary, Student

Demand goes down. So the demand for GP surgeries is reduced, and patients who require to see GPs can see them in a shorter period of time. That sounds like a great progression, Benie!

Bob Dunkley, Locum pharmacist

Deleted - apologies 

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