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A retired pharmacist's view on repeat dispensing dangers

“My local pharmacy offers to order my repeat items. They do not know I’m a retired pharmacist.”

Former independent contractor Graham Morris offers his view on the risks of automatic repeat prescribing, from the other side of the counter

I am a retired community pharmacist with many years’ experience. I have always stuck to the belief that the only person who knows what needs to be ordered on a repeat prescription is the patient, a few days before the repeat is ordered.

As I have now entered the “crumbly zone” [of my life] and the number of my prescribed items has ballooned, pharmacies offer to order my repeat items when I pick up my current supply. They do not know I’m a retired pharmacist and I have been interested in observing how this process is handled.

No doubt, the head offices of pharmacy chains across the country – in their never-ending quest to increase turnover at the expense of the NHS – expect their staff to pursue this means of capturing and increasing their turnover. Couple this with the average patient’s indifference to the costs of their medication, and you have a recipe for burdening the NHS with additional wasteful medication requests and simultaneous increases in profit for the business involved.

I have always managed my own prescription requests, for a number of reasons: medication and dose changes; “PRN” medicines that are difficult to predict usage; [and] consultant assessments.

Granted, you will have some patients whose scripts are very straightforward and almost predictable. However, there are far more patients for whom this is not the case, especially those on multiple medications.

Recently, I asked my daughter to pick up my repeat prescription and inadvertently forgot to tell her not to let the pharmacy order my repeat items. Unfortunately, she let them process a repeat prescription and I ended up with everything being ordered – regardless of whether I needed it or not. This cannot be in the interest of either the patient or NHS finances. It is unacceptable and needs to be controlled.

It is my opinion that under the [General Pharmaceutical Council’s] code of ethics, no pharmacy should be allowed to order any prescription for a patient unless the patient has been contacted – say, three working days beforehand. 

If you want the business, you should act in the interest of the patient by telephoning them and confirming their requirements near the time of the repeat request. You could then at least say that you are acting in a responsible and professional manner by saving the NHS money and communicating with patients about what they actually need ordering – not what they thought a month ago.

The existing automatic reordering of prescriptions – when you predict an order at the time the patient picks up their current medicines – avoids patient contact.

Be very aware of distancing yourself from the patient in this manner. This is particularly important if a van driver then seamlessly delivers the completed prescription to the patient.

Throughout my professional life, the number of bin liners full of unused prescribed products handed in by patients astounded me. Assuming what a patient wants, a month before they need it, will only add to this wasteful situation.

This comment was first published underneath the article CCGs stop pharmacy repeat prescription orders to save cash

Result

Do you think all pharmacies should be prevented from ordering repeat prescriptions?
Yes
57%
No
43%
Total votes: 281
5 Comments

Valentine Trodd, Community pharmacist

When you have local care homes, pharmacies and the drug distribution company all owned by the one individual the situation is wide open to abuse.

Sachin Badiani, Pharmacy owner/ Proprietor

This is why we get the local care home to order and be in charge of their own repeats. We will collect from the surgery as normal and dispense. This has saved us time and energy. We can still tell from our records whether the surgery has done or not done a script. However, it is up to the home to flag these up with surgery.

This has reduced the amount of stock held in their stock room (looking the times I have been there). We still get a lot of waste medicines back from them though (unused blisters, creams, expensive inhalers and CDs).

Mustak Kurji, Community pharmacist

I agree with Graham Morris there is far too much misuse of the system by both pharmacist  and the patient at the expense of NHS I am suprised that the issue has only just come to light

David Kent, Community pharmacist

I too am a retired pharmacist and completely agree with the comments of my colleague Grahm Morris

 

Another Pharmacist, Community pharmacist

Wishing I was retired!!!

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