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Ridge: 'Good practice' for pharmacists to explain script exemptions

The panel faced criticism from MPs over the "complicated" prescription exemption system
The panel faced criticism from MPs over the "complicated" prescription exemption system

It is “good practice” for pharmacists to “sit down” with patients and explain the prescription exemption process with them, England's chief pharmaceutical officer has said.

Pharmacists have a duty to provide “patient-centred care”, Keith Ridge stressed, which includes guiding patients “through the system” to help them determine if they are eligible for free prescriptions.

Dr Ridge was responding to a question from Anne Marie Morris, Conservative MP for Newton Abbot, at a Public Accounts Committee meeting on penalty charge notices in healthcare on Monday (July 1).

The committee meeting – attended by C+D – focused on an investigation by the National Audit Office, which found that the number of prescription checks has “significantly increased” over the past five years – from 750,000 in 2014-15 to 24 million by 2018-19 – resulting in 5.6m penalty charge notices issued to patients for wrongly claiming free prescriptions and dental work.

Explaining the “scope of enquiry” ahead of Monday's meeting, the committee said the NAO investigation suggested the “rules around entitlement to free prescriptions and dental treatments are complicated, and this is leading to genuine mistakes and confusion for many people”.

When asked whether pharmacists are trained to help patients determine their eligibility for free prescriptions, Dr Ridge said he would “expect” pharmacists to be “well trained in this area”.

Contractors have an “incentive” to make sure staff are well trained, he added.

Digital checking pilot “going well”

The real-time exemption checking (RTEC) system, which has so far been piloted at four pharmacies, allows pharmacists to digitally check whether a patient is exempt from prescription charges, before medication is dispensed.

According to Dr Ridge, the pilot is “going very well”, and will be rolled out to “a thousand or more” pharmacies this year.

In “due course”, pharmacists will be able to “check someone’s exemption status in less than a second”, he added.

Ms Morris questioned why the system isn’t being rolled out faster, suggesting it was “asking a bit much of pharmacists” to have to explain the process to individuals.

But Dr Ridge said while the RTEC system is going at a “reasonable pace”, the “different IT systems” across the sector adds to the “complexity” of rolling it out faster.

44 Comments
Question: 
Do you regularly have to explain prescription exemptions to patients?

Alba Bahja, Community pharmacist

Just to add to my previous comment , I decided to do the survey because this article made me think about te list of things we as pharmacist do for our patients .. and of course with lots of duty of care .. so please do not remind us of this !! And GPHC let us detail exactly what jobs we do in your next survey if it is to portray our numerous jobs with duty of care to our patients in mind . 

Alba Bahja, Community pharmacist

Interesting enough .. only a few moments ago I decided to complete a GPHC survey relating to our roles and responsibilities .. I was so exited to tick so many boxes of what I do on a day to day basis .. however GPHC limited the options in only three .. I could most likely tick most of them .. 

 

Ranjeev Patel, Non Pharmacist Branch Manager

There are what, over 47000 pharmacists registered in the UK, and every single one of them knows that we are overburdened. And yet Keith Ridge wants to add another job onto our shoulders? He clearly does not have the prerequisite knowledge and understanding to perform his role correctly.

david williams, Community pharmacist

Sorry for all the spelling mistakes above

david williams, Community pharmacist

I spend a lot of time posting responses, that try to stop division between us. In this case, I cannot find anything to positive to post. It is very apparent that Dr. Ridge despises community pharmacists. He believes we are not professional and spends much of his time being critical of our dispensing role. I agree we need to change, modernise, adapt, call it what you like, but we don need to. However, his naive, * comments in this interview, show his lack of understanding of the role we have played over the past years and the current role we perform. Keith, a typical political answer, incompatible with a professional. You should know better, and probably do, but do not care. You haver become part of the political establishment that pay you. Where is your duty of candour that all pharmacists are obliged to show. Blamimg others for your master's failings are disgraceful.

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

John Cleese, Production & Technical

Some quite frankly disgraceful and personally insulting comments on this thread. Ad hominem attacks don't win arguments. It's getting more like the Daily Mail every day.

Kevin Western, Community pharmacist

perhaps if Mr Ridge treated the profession he is supposed to be part of, and an "expert" on for the DoH  with some respect and displayed at least an inkling of that supposed knowledge, he wouldnt attract so much ordure. I take it personally when he says and does things that seriously and detrimentally affect my job and hence my life. 

If he cant take the heat he has other, and frankly from my point of view, preferable options. wouldnt it be fun if he had to return to working for a living!

Reeyah H, Community pharmacist

Don’t worry JC, KR won’t be reading the comments and taking notes. 

C A, Community pharmacist

Just one question how does Mr Ridge expect digital pharmacies to sit down and talk to patients hundreds of miles away?

Stuart Graham, Community pharmacist

England's chief pharmaceutical officer once again demonstrating how out of touch he is with community pharmacy. Maybe the next guidance will be to not provide treatment without evidence of exemption as part of the austerity measures he has implemented  and overseen.

Roy Sinclair, Community pharmacist

This problem has been around for years. I remember the issue  coming up in Hospital Pharmacies and it being made clear that it was not the responsibility of the Pharmacy to  check on payments / exclusions or to collect prescription fees and machines were installed at one time to provide payment stamps. There were also instances of Community Pharmacists being threatened with prosecution because they had 'helped' patients by signing for them that they were exempt when on fact the patient was not.

Perhaps Mr Ridge would have been more helpful in ensuring all Patients are informed that this is a tax that goes to the Government and that Pharmacists are acting as umpaid tax collectors. It does not just go into the Pharmacy till as a profit but is deducted from future reimbursements. I do not think I ever met a patient who paid for a prescription that understood that aspect of the prescription fee or that Pharmacists / Pharmacies will not be paid for their work in dispensing that sometimes expensive and possibly unprofitable prescription (in fact all that months prescriptions)  until some considerable time in the future. That would be good practice.    

Paul Dishman, Pharmaceutical Adviser

I used to tell patients who complained about prescription charges that charges were so high because they were paying for people in Scotland and Wales to get free prescriptions, and suggested they write to their MP

Leon The Apothecary, Student

Keith Ridge has once again showing how out of touch he is with the industry on a fundemental level with these comments.

Ebers Papyrus, Pharmaceutical Adviser

Mr Ridge everyones ultimately accountable for their actions. We’re fast approaching an unhinged collapse of the system. These savage cuts then made all the more disgraceful with the exponential increase in the calender of paperwork you’ve thrown in. The latest incarnation- prescription exemption checking. You’ve been completely ostracised from the sector, you have never valued us. Just when you can’t demoralise us anymore you start banging the non clinical drum. Staggered by your pathological disdain for the hard working teams practicing in challenging, onerous and significantly clinical environments. It’s a miracle and measure of the professionalism and devotion to our patients that an implosion has been avoided already within community pharmacy. Contractors have been reducing staff they can’t afford to lose and refinancing in the vague hope of often heard empty rhetoric from DH. It’s a disgrace.

s8chy P, Pharmacy owner/ Proprietor

I cannot remember ONE positive change he has made for our profession and our patients. 

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

Chris Locum, Locum pharmacist

*This comment has been deleted for breaching C+D's community principles*
 

Paul Samuels, Community pharmacist

You will find it under the appropriate section in the loonies handbook for pharmacy!

George Ibrahim, Community pharmacist

Give Pharmacy effective tools to do such things - a nationally searchable database linked to the NHS spine could be useful, therefore if 1 pharmacy updates a person's exemption details it's updated for the whole country possibly instead of in a silo of 1 dispensary PMR programme database..

Caroline Jones, Community pharmacist

It would be much simpler if no one other than children under 16years and those prescribed contraceptives got prescriptions free......would stop all the patients moaning when they declare how unfair it is that they have to pay a prescription charge for 2 months of medication, yet their neighbour doesn’t!

What else can you get 2 (or more) months supply of for less than £10???!?

SP Ph, Community pharmacist

BREAKING NEWS !!! The MUR service has been replaced by a new service. Any guesses?? Mr. Cheap has indirectly made it public!!!

N B, Community pharmacist

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

Robert Burnley, Primary care pharmacist

I really think it’s about time patients were given back responsibility for looking after their own business. With no responsibility it is always someone else’s fault. Although I no longer work in community I sympathise with the shrinking workforce and expanding workload community pharmacy faces year after year. When on earth are you supposed to find time to discuss exemptions with patients. Ridiculous. 

Robert Burnley, Primary care pharmacist

I really think it’s about time patients were given back responsibility for looking after their own business. With no responsibility it is always someone else’s fault. Although I no longer work in community I sympathise with the shrinking workforce and expanding workload community pharmacy faces year after year. When on earth are you supposed to find time to discuss exemptions with patients. Ridiculous. 

Joan Richardson, Locum pharmacist

Now I've wiped my eyes from the tears of laughter I just don't know what to say!  How on earth am I supposed to explain to a patient about universal credit when the government cannot even sort it out and  there isn't a box on the back of the prescription for that exemption anyway!

Get out of your ivory tower Mr Ridge and come and see how the other half live!  FMD has drastically increased the time it takes to dispense a precription and no doubt electroninc exemption checking is also going to be a nightmare!

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

Paul Dishman, Pharmaceutical Adviser

Ridge should try working in a community pharmacy instead of sitting behind a desk making inane suggestions. 

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

Seal Patel, Community pharmacist

Tick what you want and sign it. Its not our responsibility to know why you get something for free. It's funny how patients know they don't have to pay but have no idea why that is. The clown Keith Ridge needs a reality check and realise its not a pharmacy issue but something a patient needs to sort out themselves

Stuart Nicholls, Community pharmacist

Couldn't agree more with all these comments, get out of your ivory tower and come and spend some time in a pharmacy and see how low moral is we'reloaded with more & more tasks with decreasing renumaration!

Paul Gadsden, Locum pharmacist

Make everything like Wales and Scotland and give free prescriptions with cost funded by a small increase in national insurance or tax then expenditure on gadgets time of pharmacists worry of patients employment of bureaucrats in counter fraud office would all stop and life would be miles easier not having to worry if people are exempt or not and hmrc could do the job at which they are experts namely claiming taxes

Sham Kiani, Community pharmacist

It would be good practice if the Chief pharmaceutical officer refrained himself from making such stupid comments.

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

V K P, Community pharmacist

What incentives is this joker talking about? He wants the pharmacy sector to do all the work but he will not put any resource into but would rather take funding out and give it to the GPs. Take the exemption policing to the GPs. How is exemption checking a clinical role? Which part of the BNF has prescription exemptions on?

 

 

 

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