Layer 1

GP pharmacist: I hope community pharmacy is more proactive in future

“It offends me that community colleagues maintain we ‘closed our doors’ to patients”

Community pharmacy was behind GP surgeries in reacting to COVID-19, says the GP Pharmacist

My practice’s response to the COVID-19 pandemic happened quickly and early. The attempts to reduce footfall began around March 12. By the time official lockdown was announced, we had been limiting initial appointments to telephone-only for nearly two weeks.

My memories of those early weeks are a blur of trying to rein in excessive over-ordering, juggling inhaler shortages, and managing bizarre requests courtesy of viral social media posts – such as those for COVID-19 “rescue packs” of steroids and antibiotics . After those chaotic initial weeks, policies were put in place to reduce the number of staff in work at any one time.

For me, this meant homeworking for the first time. I was apprehensive about this, having been used to dynamic workplaces with plenty of colleagues around to bounce ideas off and discuss concerns.

I did worry that my motivation levels would drop somewhat. However, the technology worked well, which meant that I could access all the practice systems. This enabled me to deal with medication queries, update clinical posts and continue medication reviews – albeit by telephone.

I relished the new approach to meetings. We have far too many in primary care and they are often a protracted process played out in airless, artificially lit grey rooms. The use of virtual platforms has meant that these are now much more purposeful, do not require travelling, and are generally much more efficiently expedited.

I also took the opportunity to encourage doctors to embrace electronic repeat dispensing. While this was a steep learning curve for all – and not without a few problems – it is now an established option for patients. Something I had been slowly pushing for years was accomplished in months.

We are now in a restorative phase. Although footfall in the building is increasing again, it is obvious that there will be a continued use of technology to increase virtual contacts and replace much of the old face-to-face work, especially for routine reviews.

I’ll be honest though, I think GP pharmacists had a much easier time during the pandemic than our community pharmacy colleagues.

In the early weeks of the COVID-19 outbreak, the unprecedented stress they were under was obvious from the ever-increasing queues for local pharmacies. The danger of a pharmacy closing under the pressure was very real.

It continues to offend me that many community colleagues maintain we “closed our doors” to patients. We didn’t, but everything went through a phone call triage first. However, it is true that GP practices were far better placed to protect themselves in the initial stages.

Community pharmacies seemed about two weeks behind GP surgeries in responding to the challenges. I visited one pharmacy about 10 days after we had implemented access restrictions and was shocked to see that there had been no attempt to impose social distancing for patients or staff. When I asked a member of staff about this, they said they hadn’t had any direction from above.

I just hope that community pharmacy is more proactive in coming out of this than they were going in – ensuring appropriate recognition for the critical role they played in supporting patients and the NHS.

The GP Pharmacist is a former community pharmacist working in a general practice

38 Comments

Adam Hall, Community pharmacist

If GPs didn't close their doors, why have they been written to by the NHS to TELL them to offer appointments?

Anonymous Anonymous, Information Technology

Thanks for that phoctor! You really are the epitome of an uppity wannabe GP type pharmacist... And the exact reason I HATED working in a GP surgery!! Had you come into my pharmacy with that condescending tone I'd have sent you packing back to your 'homeworking'!

Unlike the hardworking (yeah right) GP surgeries we weren't able to send patients away as our local surgeries had told patients that they "weren't open but you can visit your local pharmacy instead".

I'd really like this blogger to be shown the door and perhaps C&D might take notice if we all stopped paying for their CPD courses, etc until she is removed! After all it's Chemist's and Druggists not Wannabe Play-pretend Doctors!!

, Community pharmacist

 

When I first saw the new bloggers apponted by the C&D I was most interested to read this blog from a GP pharmacist as I wished to learn more about the role to proactively facilitate working together and to inform those wishing to change roles.

Unfortunately the role of this blog to inform has been sadly squandered.

In particular, this article has been written by someone with an ignorant, ill-informed, unprofessional, community bashing agenda. Her previous posts are all written in the same light and are utterly valueless.

All my local Pharmacies (multiples and independants) were actually one or two weeks ahead of surgeries and their own head offices (where applicable) to implement social distancing, increasing cleaning of pharmacies and screening protocols. We all proactively kept incontact with each other via our personal mobiles as our phone lines were permanently jammed. I am immensly proud of the proactive coordinated response we all made during an unprecedented emergency.

I would like to proactively recommend to the editors of the C&D that this blogger be replaced with someone more professional.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Seems like a lot of the new bloggers have disappeared - namely the ones who worked in community pharmacy who obviously now don't have the time for blogging, unlike our GP-pharmacist colleague who has to find something to fill his day up. I actually liked the locum blogger best because his avatar looked like me, i.e. knackered and ready for the scrap heap.

, Community pharmacist

CP

A CP Manager, Non Pharmacist Branch Manager

Wait the now. Haud the bus. We were two weeks behind? Certainly in Scotland where we don't have EPS, and every script is paper, I've never experienced the unprecedented volume of scripts coming down from the surgeries; as well as the volume of new patients arriving through our doors every day - all because the surgeries closed their doors, and asked patients to nominate a pharmacy for their scripts to go to (which overall is fine). However due to this blanket door closure, and the surgeries telling the patients to come in to the pharmacy for any queries meant that the numbers doubled if not tripled overnight. 
 

I feel that it would be very naive of anyone working in a surgery responsible for issue of a prescription, not to take accountability of the pressure you state we were under. It certainly wasn't community who were driving through double and triple prescriptions for anything ranging from inhalers (again, understandable) to their regular repeat medicines. 
 

The pressure was then again put on CP shoulders to decide if we wanted to issue for one script's worth or to issue the duplicate(s) sent our way. 
I am actually really disheartened that C+D actually allowed this article to be published. 
You are offended over the fact that you closed your doors? I am offended by everything in that article

Chris Locum, Locum pharmacist

It seems members of the same profession can literally be worlds apart - and have been for many years. It is a factor in why Pharmacy got abysmal treatment financially and professionally from others.

Kevin Western, Community pharmacist

Is your name Richard? What do(any?) Friends call you?

Benie I, Locum pharmacist

Still better to be a Doctor than a Pharmacist.

Farmer Cyst, Community pharmacist

Community pharmacy was behind GP surgeries?

 

Around here the pharmacies stayed open throughout, dealing with huge script volumes often with their workload exacerbated by dubious practices by surgeries directing scripts.

 

Plenty wrong with community pharmacy, but this is a very odd thing to say.

Ebers Papyrus, Pharmaceutical Adviser

Salaries and pensions in the GP framework create a different dynamic and incentive similar to teachers. Community pharmacy is both cost-effective and highly competitive, this is fundamentally at odds with the NHS politically.

Chris Pharmacist, Community pharmacist

The covid outbreak has hugely exposed the discord between public and private sector. GP surgeries are operating to protect GPs and surgery staff no matter the cost, pharmacies operate to maintian profit levels as much as possible.

Pharmacies may be riskier enivronments to work in but at least the reason for their existence (patients) hasn't been forgotten.

Getting Shorter, Community pharmacist

"The covid outbreak has hugely exposed the discord between public and private sector. GP surgeries are operating to protect GPs and surgery staff no matter the cost, pharmacies operate to maintian profit levels as much as possible."

The vast majority of surgeries are private companies in one way or another - and very focused on protecting their income. If you ever go to any local meetings where money is/might possibly be involved, you'll soon see this.

(Not saying this is a bad thing as such, everyone needs to make a living and why not make the best you can. They are mainly the same as we are - private organistions which are contracted to provide services to the NHS, and who provide other products and services as they wish (eg, private travel vaccinations, medical reports, signing paperwork). Just don't get sucked into believing that surgeries are charitable organisations with the GPs living in cardboard boxes because they only come to work for love of the job)

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I have worked closely with GPs. They are OBSESSED with money.

Reeyah H, Community pharmacist

I can't believe what I'm just read. You DID close doors! What's offensive about us stating the obvious!!!!

Gerry Diamond, Primary care pharmacist

I;m retired GP based pharmacist and think that community pharmacy did a splenid job and continues to do so. As although patients may have to queue up, they still could speak face to face perhaps via a perspex screen with a very well qualified healthcare professional to give them reassurance, advice, support and or refer. We should not underestimate the great work done by community pharmacy teams throughout the country and they should be very proud indeed.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Thankyou. This is much appreciated by this particular train wreck of a community pharmacist at least.

Cymraeg Locum, Locum pharmacist

"It continues to offend me that many community colleagues maintain we “closed our doors” to patients."

 

Well, I hate to break it to you but many GP surgeries did and continue to do so.

Its the only way the staff could record their dance videos for TikTok. And no I'm not joking. And yes this did offend me.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I'm offended at the implication that we are liars. It is very much the case that GPs pro-actively discouraged patients from troubling them. You only had to listen to the half-hour lecture on the telephone answering system to realise this, and it is unfortunately now having the effect whereby patients are now suffering more serious conditions than they would have if diagnosis had been sooner. I can only speak as I find and it may be that this GP pharmacist's practice bucked the trend, but in my experience, GP surgeries have battened down the hatches (in my own surgery they have actually built a new hatch to prevent patients even entering the building to speak to a receptionist) and looked after No1.

'In the early weeks of the COVID-19 outbreak, the unprecedented stress they were under was obvious from the ever-increasing queues for local pharmacies. The danger of a pharmacy closing under the pressure was very real' - this says it all. There was NO stress to GP practices and never a chance of one closing because they ALREADY HAD.

locum pharmacist, Community pharmacist

Is it perhaps the case that some GP practices coped better than others as did some community pharmacies?
I'd imagine it would be a whole lot easier to be proactive sitting at my kitchen table than it would be whilst faced with increased workload, reduced staffing levels and queues of patients. Unfortunately this opinion piece only highlights why the relationship between some GP pharmacists and community pharmacists is not as good as it should be. 

 

 

 

C A, Community pharmacist

So you are saying when there isn't time to eat, drink, or answer calls of nature, strategic planning isn't at the forefront of your mind? How very un-proactive of you!

</sc>

Paul Dishman, Pharmaceutical Adviser

It must have been nice to work from home and not put oneself in danger by actually meeting patients 

Ronald Trump, Pharmaceutical Adviser

 

Community pharmacies couldnt close their doors because people still needed to physically pick up their prescription medication and buy medications. I'm sure most would have otherwise. It's the nature of the business. Even at virus peak my local GP surgeries were still seeing very sick patients if needed. Only doing tel consultations for non-serious illness. I think lots of pharmacy chains and multiples were a bit slower to react than surgeries as they are bigger organisations whereas surgeries could react quicker and make decisions more independently.

Let's hope we learn and get it right for the next pandemic. Maybe all pharmacists in all sectors can work to together without sla**ing each other off :)

 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I hate to disagree with you on this one, Ronald, but I have seen so many patients that have been sent to us, with conditions that need GP input, be it skin infections to pain relief (why oh why do SO many GPs think we can sell codeine over the counter? We'd all be driving Ferraris if we could) that I've lost count. I've been sending them back to the surgery with the message that the GP still holds the duty of care to the patient and is obliged to 'see' them (obviously not physically - patients are far too infected for that) for conditions that would ordinarily be seen by a GP.

I wish your last sentiment could come true though. I'm fed up (and have been seriously guilty of it in the past myself) of all the discord between the different wings of the profession. Trouble is, by nature, community pharmacists are loners and view other pharmacists with deep suspicion (how many times have you had someone at the counter say they are a pharmacist and your first thought is 'smart-arse'?) so I think we are the root of the divisions.

I'm sure you are right that we were slow responding though - there must have been a better way than letting everyone come into the premises exactly as they normally would. Maybe a counter at the doorway would have been better and staff picking from the shelves for patients (only in the little stores obviously - wouldn't work in an out of town Boots) but it's far too late to change now. Still, the death rate seems to be still going down which is an encouraging thing. Maybe the virus is mutating into a weaker strain - they evolve rapidly in response to changes in host behaviour, just look at what happened to the HIV virus.

Ronald Trump, Pharmaceutical Adviser

Yes, as per your first point I think community pharmacy were hit hard by patients with non-serious illness that would still need GP/Clinical Practitioner input e.g uncomplicated LUTI, bpv,  BV etc conditions that would need further examination/ investigation

This is why I think it's important for us to train future pharmacists to  mop up some of these conditions and get paid well for it

we need more money pumped into funding , education and training and to redesign undergrad and postgrad trainging but I think rishi has spent it all on 50% off mcdonalds

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Total agreement on this one, Ronald.

I feel a bit sorry for Rishi though, because a lot of smaller eateries have been saying on the radio this morning that the eat out scheme has saved them and their suppliers from going under. He can't keep everyone happy, but there is definitely much suffering to come for everyone until this is paid back. I think any sector that relies on public funding (except for the Golden Boy GPs of course)  can dream on for any decent money coming their way for this generation at least.

C A, Community pharmacist

Having seen figures for ABx - I would argue that some of the clinician input for the conditions you've mentioned is limited to "here is an ABx go away"

Kam Lung Ng, Superintendent Pharmacist

I don't think use of technology would be allowed. Are we allowed to do MUR with technology so that the patient does not need to be in the consultation room? Perspex screen was quickly installed in a lot of pharmacies at the beginning of lockdown. This is the kind of former community pharmacist who just doesn't understand community pharmacy and deserve to be working from home in front of the computer screen (with his feet up) as opposed to us working our socks off behind the perspex screen with real thread of the pandemic.

TC PA, Community pharmacist

"Community pharmacies seemed about two weeks behind GP surgeries in responding to the challenges"

This view seems to be based on a visit to one community pharmacy on a non-specified date. I think you need a bigger evidence base before drawing these types of conclusions.

Alexander The Great, Community pharmacist

Yes lol, i think this GP pharmacist is here to troll us. NONE of their articles have been useful to us.

Pages

Job of the week

Accreditation and Recognition Panel member positions
Home Based
On application