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'The new pharmacy contract should include a MDS service rethink'

"Is the value of a safely dispensed item really only £1.26?"

The Contractor has some suggestions for PSNC before it starts negotiating the next pharmacy contract

For far too long contractors have offered a fantastic service because they could just about afford to. However, recently my pharmacy stopped taking on any new monitored dosage systems (MDS) patients due to lack of time, and therefore safety.

We now signpost to other pharmacies still willing to take them on. Bravo to them, as I’m certainly not putting any more pressure on my staff.

Therefore, I would like the Pharmaceutical Services Negotiating Committee (PSNC) to consider the following when it comes to discussing the next pharmacy contract:

1. Rethink MDS

I’m a little fed up with doctors simply sending patients to ask for MDS like it’s a walk in the park! It’s time-consuming and costly.

2. The single activity fee should be higher

Is the value of a safely dispensed item really only £1.26?

3. Fair remuneration

I’m all for a service-based contract, but we will need staff for it and that means fair remuneration for services.

4. Healthy, happy staff

Healthy living pharmacies need healthy staff to run them. The staff need to be paid well – like they deserve – and that can only come from higher up. At the moment, the morale of staff and contractors is at an all-time low.

5. Keep pharmacies open

If the Department of Health and Social Care still wants pharmacies to close, they need to prove how that will save money. If dispensing volumes remain the same, how will closing branches save NHS funding?

6. Cover the printing costs

This one is just for amusement, but I don’t even want to pay for my printer’s toner or drum. Why should we fork out from our measly electronic prescription service payments? There should even be a ‘toner and drum’ fee!

Here’s hoping for a contract that actually makes sense – or we will all need to shut up shop and go home.

The Contractor is an independent pharmacy owner in England


Leon The Apothecary, Student

I remember reading that MDS adds very little in terms of patient compliance, and for the time it takes and additional paperwork involved, add little value to a pharmacy's margins not to mention everything becomes unlicensed as soon as you take it out of it's original packaging with stabliry data typically lasting seven days only, and with 28 day prescriptions you are required to give the entire amount in one go as per the pharmacy contract.

John Urwin, Community pharmacist

We were first paid to provide reasonable adjustments under disability legislation to enable patients to manage their own medicines a few years ago. This was originally to be an item of service fee for providing support but the DH rapidly took fright at the possibility of being sued if help was refused by a pharmacist. So we ended up receiving a few pence added as a flat rate to the dispensing fee.

The decision as to whether a pharmacy provided what rapidly became the Universal Panacea, an MDS tray, was left to the pharmacist.

Pretty soon we reached the present situation. Pharmacies pressured for MDS purely to enable Care Companies to employ cheaper, less well trained carers. It can be argued that provision of a carer, paid for, to a greater or lesser extent, by the state is a "reasonable adjustment" under Disability law and why should the state pay for two "reasonable adjustments"?

If  provision of MDS is for the convenience and profit of care companies I would suggest pharmacists refuse free supply. The script may go elsewhere but do you actually make any profit by supplying MDS in this situation?

Independent Dave, Community pharmacist

Yep yep and yep! I dred any patients asking if I can take them on as a tray. 50% of one of my staff members salary (full timer at a decent wage) simply goes on MDS trays, and we only gain 200-300 items a month out of it. If you then also take into account the cost of trays, deliveries etc with a poor measly activity wonder why would you ever say yes to any! The answers simple, to help care for those who really need and can no longer support themselves in the same way (some of whom have been loyal customers over the years). But pharmacy is not a charity, and it needs to stop being treated like one!! Of MDS is not eventually funded then there needs to be collective meeting between our leading bodies to say we will no longer do provide such a service until we all at least get what is fair!! 

Pharma Tron , Community pharmacist

Yeah careful what you wish for... I'd rather be in control of MDS decisions so I can simply respond to the carer demanding blister packs for their 'service users' calling me me duck in between drags of their fags by asserting it is my ultimate decision to supply, not theirs. Dont sell out as the tail will inevitably wag the dog on that if it happened.

Chemical Mistry, Information Technology

Pharmacy is health profession not social services


Am afraid to say will not get any of them, however if all pharmacies in the area say no to the MDS then it soon filter back to the powers be, and found mainly to private care companies requesting who get paided a fortune for the patient but not passed on to the carer who actually looks after them and no law stating that they cannot adminster meds from original packs, if give wrong meds then blame the care company who employ the carer and pay them a fare wage for the job!




Tired Manager, Community pharmacist

Was that a pig flying past the window I saw earlier?

N O, Pharmaceutical Adviser

All I can think here is, PSNC will add all the demands of extra services including the MDS under one umbrella and then  accept an increase of 2p per item. This means, we can then not refuse any service (like MDS, free delivery, etc) just like the DDA scheme!!! So, better watch for what we wish!!!

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