I have a confession to make. I no longer want to be a dispensing chemist.
This archaic expression still used by over 50 pharmacies in England projects the traditional image of the apothecary compounding a trusted nostrum, but that’s not what we do.
After an intense four-year degree course and another year’s practical clinical experience, what we pharmacy professionals do in the 21st century is initial labels on tubes of emollient and oversee the sale of 32 paracetamol tablets.
“Hang about!” I hear you cry. “There’s so much more to our job than that. We are the final safety check, the clinical surety that guarantees protection of the public.” Yes, I agree wholeheartedly. Pharmacies must be the place for patients and public to be sold or supplied medicines, and a pharmacist must always be present.
“And another thing,” I hear you ask, “what about local and advanced services?” And you’d be right, because we’ve agreed time and again that services are the way forward for pharmacy and, despite the myopic pronouncements of England's chief pharmaceutical officer, we have embraced service provision as much as we can.
The problem is that we have reached the limit, and that limit is the pharmacist.
As I’m passed a signed medicines use review consent form, I look up from the dispensary to see two patients waiting for the pharmacist and an anxious looking teenage girl needing emergency hormonal contraception.
The next item requires a new medicine service consultation, but first there are two buprenorphine scripts to supervise, and when I finally emerge from the consultation room it’s lunchtime and there’s a queue of waiting scripts to be checked, which I prioritise by searching for the one for the children screaming loudly and pretending the walking sticks are light-sabres. And in addition to all of that I am now doing 20 flu jabs a day.
To transition from dispensing chemist to clinical service pharmacist I don’t need to be able to leave the pharmacy, I need changes to supervision legislation to leave the dispensary. Yes, C+D's editor was right to ask about the lack of sector-wide consultation, because changes to supervision rules risk bitterly dividing our profession. It’s great that Community Pharmacy Scotland get the idea, but actually someone beat them to it.
There are already very profitable, successful dispensing businesses where the clinician in charge, has little or no involvement in the dispensing process, but must be present and responsible.
The dispensers and technicians have managed for decades to safely and effectively provide prescribed medication to patients without direct supervision, while the clinician is seeing patients in the consultation room.
That is the model that we should adopt – where a trained, registered healthcare professional can initial labels on tubes of emollient and oversee the sale of 32 paracetamol tablets, while I’m in my consulting room. But I would always be on the premises, to address the complex clinical scripts, brought to me under a strict and effective protocol.
I don’t want to be a dispensing chemist. I want to be a dispensing doctor.