Layer 1

‘NHS plan for volunteers to deliver medicines is a death trap’

“We aren’t talking about delivering a box of vegetables”

NHS England’s plan for well-meaning volunteers to deliver medicines for pharmacies puts patients’ lives at risk, says Mike Hewitson

Volunteer army? Great, that’s all we need.

I really hate it when good-natured people get manipulated by those who should know better. And thus, I stand alone in my crusade against a tsunami of volunteers being pushed to do NHS England’s dirty work.

It may be a lonely position, but I am certain in my conviction that I do not want a load of well-meaning amateurs delivering medicines or coming in to collect prescriptions on behalf of others.

Chief executive of the General Pharmaceutical Council, Duncan Rudkin, a man I have a lot of time and respect for, said in an NHS England webinar on March 25 that responsible pharmacists using volunteers as set out by NHS England wouldn’t have anything to worry about if something went wrong.

It’s one view, but it’s not exactly the whole picture. While Mr Rudkin may speak on behalf of the regulator, he has no power over the courts. Be it a civil or even a criminal prosecution, he has no power to stop an angry relative, or the backlash from a community if someone were to die as a result of a mix-up with medicines.

We aren’t talking about delivering a box of vegetables: get the wrong medicine to the wrong patient and they might die. People have lost their lives as a result of delivery errors. While it is absolutely correct that pharmacists should make their own professional decisions about what corners they’re comfortable in cutting, I would suggest that using volunteers to deliver medicines has potential ramifications.

I’m the councillor for a ward in South Somerset. I can tell you that the management of volunteers is a real art. Without the motivation of payment you’re really only relying on the goodwill of the individual. It doesn’t matter how you train them or what instructions you give, volunteers will do what they want.

In short, the scheme that NHS England has dreamt up is nothing short of a death trap. Whether someone delivers the wrong medicines, the right ones at the wrong time, or doesn’t deliver them at all, there are risks to the reputation of the pharmacy. When it all washes out, nobody is going to remember that it was a volunteer driver, just that the pharmacy provided an unsafe service.

Another big risk is that volunteers could give advice when people see them delivering medicines. The patient might ask “how do I take these?” Or “are these safe with my other medicines?” There have been very real examples where that has gone seriously wrong, and if it does, you won’t have Mr Rudkin to hide behind.

My pharmacy is getting hundreds of requests for deliveries every week. It’s going to be one hell of a logistical operation staying on top of who has delivered what and where. If we don’t have a mechanism to provide management oversight, how can we say we are providing a safe service? How can we find a prescription if the patient says they haven’t received it? What happens when the patient insists that they haven’t had it and wants the medicines redelivered? Who is responsible?

Volunteers have the potential to create as much work as they solve, and it will take a full-time member of staff just to manage their deployment. Plus, every patient who walks through our doors right now presents an infection risk, so I’m not very keen about a dozen more people coming in to collect prescriptions.

These well-meaning volunteers are merely pawns in a much bigger game. NHS England appears determined to deny pharmacy any additional funding throughout this crisis. If it was acting in good faith, my feeling is that we would have seen the service specification for the national delivery service by now, more than two weeks after it was announced.

We’re in a national crisis, and I’m not buying bureaucratic excuses. I hope those civil servants have their stories straight for the inevitable public inquiry that will examine this strange period.

We’re in exceptional times, and this means were all going beyond normal business continuity measures. The five-year pharmacy funding contract was already insufficient before all of this kicked off, so how can we be expected to maintain a service without the resources we need to keep patients and staff safe?

Mike Hewitson owns Beaminster Pharmacy in Dorset

The GPhC declined to respond to this article. C+D has asked NHS England for its reaction

18 Comments

Paul Lowndes, Pharmaceutical Adviser

This is clearly a bit of a controversial topic but there are resources to help pharmacists and owners navigate and choose the best option for their customers.

This free training resource might be of interest:

https://elearning.easygenerator.com/6d6f5657-9d20-4179-8840-510ad818268d/#login

Leon The Apothecary, Student

I get the impression there is more to this than meets the eye. Like this is a test on if Pharmacy truly needs funding for delivery services in the future; what I am seeing is that even during a crisis where people shouldn't be able to freely access Pharmacy easily are finding they are getting their medicines in a timely manner.

What does this mean for future developments? 

Brian Smith, Pharmacy technician

Community pharmacy delivery drivers are all highly qualified and skilled pharmacy professionals that never make any errors and deliver items perfectly and without incident every single day!!!

Basically these are strange times, people need help at the moment. Many people have signed up to lend a helping hand to those unable to leave their homes. Isn't it better that a few people receive their meds rather than not? The responsible pharmacist will obviously need to make the decision for themselves about allowing a volunteer to pick up and deliver the meds. And i've signed up for the service to help where i could and in the space of 4 weeks i haven't had a single alert so maybe the volunteer army hasn't been necessary anyway. 

david williams, Community pharmacist

I have always thought it was risky. There is a legal obligation on the contractor to ensure reasonable care in the supply of the product. Just because assurances have been given, does not make it legally correct. Home secretaries have found themselves in court, and lost? The courts will decide the law, not Duncan Rudkin, who should keep his legal opinions to himself, until a test case proves otherwise. (I hope it does not even arise). GPhC is not the most powerful body in the land and would do well to remember that before giving any assurances. I will admit, to not knowing the full context of his statement, but does seem to mislead by stating ". Pharmacy professionals acting in accordance with the standards and using NHS Volunteer Responders in good faith in line with the service specifications of the Pandemic Delivery Service will not be regarded as responsible by us for actions of other people outside of their control" The "by us" gives me little reassurance of "by the courts" I believe GPhC should clarify this statement to indicate a legal view, or advise us that it has no legal bearing and we are on our own if the proverbial hits the fan

John Cleese, Production & Technical

What about the risk of doing nothing? Of vulnerable patients going without medicines, without this service? There are both pros and cons here.

Martin Jones, Community pharmacist

I've signed up as an NHS Transport Volunteer (TV) and here is my take on it, for what it is worth. I'm expected to transport medicines and/or equipment for the NHS. Part of that is picking up prescription medicines for isolated or vulnerable patients - but that is not the only role I will have. They may use a pharmacy that doesn't have a delivery service (like any of the supermarkets, for example) or it could be that their need cannot be met by a delivering pharmacy (huge demand, staff absence). Under those circumstances I'll effectively be acting like a neighbour picking their prescription up for them. There is no contractual relationship between me and the pharmacy, just as there would be none with a neighbour. I've read about the proposed agreements that DR is suggesting pharmacies sign with volunteers. I think that is a mistake on two grounds - firstly because I would flatly refuse to sign it. Secondly, by signing an agreement, the pharmacy is putting itself in the firing line by appearing to be giving direction and taking control. Why do that? You treat me just like a neighbour (albeit an accredited one) and let the NHS look after me (including if things go wrong). I don't anticipate being used as an unpaid pharmacy delivery driver - calling in to pick up tote boxes of bags - this is a service for isolated and vulnerable patients only.

That's exactly my take on the service. I'm working on the assumption that one volunteer would be picking up for one sheilded patient. Ideally I'd want the patient to phone and let us know the arrangement before handing over the medication.

Martin Jones, Community pharmacist

Hi AB, from what I understand (haven't had a callout yet) I'd have a callout request on my phone that I could show as authorisation to the pharmacy staff so that they could confirm that my request is valid. Martin

Thanks Martin, that would make a lot of sense

Adam Hall, Community pharmacist

We don't deliver; we don't organise others to deliver. We pass on details of people who have said they will collect on behalf of patients but, from our point of view, the patient initiates the collection and takes responsibility for the person collecting on their behalf. Not an NHS (funded) service, so not my problem

O J, Community pharmacist

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

N patel , Non Pharmacist Branch Manager

OJ....I WILL GIVE U THE BENEFIT OF THE DOUBT AND ASSUME THAT U WERE POSTING TONGUE IN CHEEK...N=BUT WHAT YOU SAY IS UNFORTUNATEY TRUE.. NO ONE WILL REFUSE TO DELIVER ...NO ONE WILL QUESTION WHY WE FOLLOW IDIOTIC RULES MADE BY DONKEYS BLINDLY....JUST REMEMEBER OJ THAT  WHILST GO SURGERIES SHUT SHOP PAHRMACY CARRIED ON DOING WHAT U CALL COUNTING SMARTIES PUTTIN THEMSELVES IN HARMS WAY.....THE ONLY PROBLEM IS THAT HIGHER POWERS WILL SOON FORGET THAT AND REWARD GPS ETC WITH THEIR LARGESSE 

C A, Community pharmacist

Is there really a need for caps?

N patel , Non Pharmacist Branch Manager

NO ...BUT I LIKE IT THAT WAY

John Urwin, Community pharmacist

Fair enough, but your comments may reach a wider audience if you used lower case. I can't be the only person who switches off at the sight of a paragraph or more in capitals. There is a reason books and newspapers are predominantly in lower case.

Kevin Western, Community pharmacist

Absolutely. It was always going to go this way. If volunteers are going to do it, let someone else organise them, I'm not.

N O, Pharmaceutical Adviser

I am with you Mike on this. You are absolutely spot on.

Just noticed how the CPS got £5+ million in additional funding in addtion to their normal increase in annual contract. Why is the NHSE shying away??

C A, Community pharmacist

I think PSNC needs to take a notepad and go meet up with CPS

Job of the week

Pre-registration Pharmacists 2021
London (South), London (Greater)
Competitive package