The history of pharmacy extends into ancient times, when the cultivation of plants played a key role in the compounding of cures for ailments. Pharmacy has a rich history and should, by rights, have evolved into a well-understood profession that is respected for its expertise in medicines.
Today however, we find ourselves facing the very real possibility of becoming the “prescription police” – so nicknamed by the Royal Pharmaceutical Society in May – expected to assess patients’ exemption status in the government's crackdown on prescription fraud.
The proposed system, already being piloted in community pharmacy, requires pharmacies to check patients’ exemption status against a digital database before dispensing prescriptions. While considerable cost-saving to the NHS is a potential positive to the proposal, what about the cost to community pharmacy?
If we allow ourselves to take on this new role, when will it end? Colleague time is already spread thinly as the workload in pharmacy increases. An ageing population is demanding more prescriptions, there is an ever-increasing number of services to deliver – often without the staff capacity to do so – and now we have to deal with the Falsified Medicines Directive. Adding to the burden of work serves only to reduce the time dedicated to more meaningful areas.
To the NHS Business Standards Authority, a simple check of a prescription might seem like the smallest addition to our standard operating procedures, but what about the outcome? Are we to take more time away from other work to discuss a patient’s exemption status, when a patient becomes distressed at an “unknown” message on the screen?
We should not be the gatekeepers to healthcare, nor should we assess exemption in any greater detail than we already do. As healthcare professionals, why are we expected to take on an administrative task that should be done centrally?
As a community pharmacist, I have had one or two occasions where patients have admitted that they have been fined for prescriptions, usually due to expired pre-payment certificates. I have not had to get involved, nor do I feel it is appropriate for me to discuss exemption status – unless a patient has questions about the process.
We should be maintaining the image of healthcare, not giving the impression that we are policing prescriptions. Patients need to feel comfortable enough to have open and honest conversations, so that we can use the best of our skills to improve their quality of life.
Patient-centred care and improving the health of the general public were key factors that attracted me to become a pharmacist years ago. Making changes to support medication regimes, assisting those in need and empowering people to make healthier choices are the foundations of the work we do.
As a profession, we pride ourselves in our accessibility and our non-discriminative approach to healthcare. If we continue to accept these administrative tasks – which jar with our history – then we continue to lose focus on who we are and why we do what we do.
Laura Lockwood is a community pharmacist based in north England