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Xrayser: The FMD has left me with a £600 paperweight on my counter

"I’m left wondering what became of the paperless world that we were promised 20 years ago"

Xrayser rails against the NHS's backwards approach to technology

Our wholesaler driver arrived smiling, usually a worrying sign. “I'm super speedy this afternoon,” he announced. “The personal digital assistant scanner is bust, so we’re back to paperwork and it’s so much quicker!”

“He’s right,” I thought, as I considered all the electronic processes around me: the responsible pharmacist log, the fridge thermometer, our repeat prescription system, and as for the EPS – don’t get me started.

“Oh, thank God. They’ve done Mrs Smith’s repeat dispensing dosette scripts on paper,” said our pharmacy technician Jen. “It’s so much quicker to process than EPS repeat dispensing.” I’m left wondering what became of the paperless world that we were promised 20 years ago.

The technology enabling the NHS to send easily readable documents from one location to another with security is available, but it’s not in place, and so we continue to use paper FP10s. And we still send faxes, because it’s quicker and more practical to stick a piece of paper into a slot that unequivocally pops out at the recipient’s end than to amend or annotate pdf documents and send them via shared email accounts, to sit on a server unread.

The NHS is not really set up for technology. I was giving a talk to a stroke group this afternoon, and my leaving advice was “never assume anything happens automatically, the NHS administration is horrendous!”. This will only get worse.

Thousands of years of development meant slate and chalk eventually became paper and biros, because that proved the most effective and user-friendly visual communication device. Although the pace of development has since increased 1,000-fold, it seems the NHS has not understood the adoption of user-friendly technologies, like email and contactless payment. It seeks instead to use convoluted security systems that would impress MI6 yet are disproportionate to any true threat.

Talk of disproportionality brings me onto the emperor's new clothes that is the Falsified Medicines Directive (FMD), the EU’s anti-counterfeit legislation requiring all pharmacies to scan barcodes on packaging at the point of dispensing. Regardless of hard or soft Brexit, how long will it be before a think group sums up the cost to the NHS of this pointless, ineffective, naval-gazing travesty and calculates how many patient lives could actually have been saved if that money had been spent on clinical care?

It beggars belief that NHS England and the Pharmaceutical Services Negotiating Committee have allowed this to proceed at an individual pharmacy level, and yet I have had to buy a £600 paperweight with a scanner that sits uselessly in the corner of the dispensary, when all that was needed is a standard operating procedure that says “all drugs must be purchased from reputable approved wholesalers”.

You could even just write that on a piece of paper.

A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser


Em, Locum pharmacist

There's a lot of misinformation or lack of understanding surrounding FMD. Wholesalers have to scan their packs before passing them to the next person in the chain just like everyone else.

Robin Davies,

Wholesalers do not have to scan everything.


£600 for a 2D scanner? They must have seen you coming

Oliver Staunton, Information Technology

£600 is far too much! Should be less than £100

Sachin Badiani, Pharmacy owner/ Proprietor

I think it's one of those standalone terminals if I'm not mistaken?

Anyway, I have found the 2d barcode scanners much better at scanning the ETP barcode tokens then the old 1d scanners. At least it will have some use... Although the FMD Windows app is not able to scan white barcodes on dark background e.g. Betmiga, Diprosalic Ointment, etc. /facepalm

Darren Powell, Community pharmacist

Your scanner might have an inverted scanning mode, and your supplier should be able to tell you how to switch this on. Once in this mode, the Vesicare packs etc with black backgrounds are scanned more easily.

Benie Locum, Locum pharmacist

More work. Less Money. 

Joan Richardson, Locum pharmacist

I arrived at a pharmacy on Saturday to discover a scanner all connected up and ready to go!  So I asked "what exactly is it doing"? expecting to be shown messages on screen either verifying the packs or decomissioning them.  The dispenser had no idea as the man from head office had just told them to scan the packs!  It is probably a tiny scanner flashing red to look as if it is doing something more exciting!

ethyl bromide, Community pharmacist

So why spend all that money when it's a tad tight? Because it's a step nearer remote supervision/ automatic dispensing with everything verified electronically.
Compared to the cost of this, saving a Pharmacist salary in every Pharmacy is a good deal.

Ben Merriman, Community pharmacist

As usual, I agree with most of your thoughts. My only scrap of optimism re: FMD is that we'll finally have the ability to identify any instances of stockpiling of medicines. Whether anyone does anything about it, of course, is another matter entirely...

C A, Community pharmacist

Pretty sure that you would need to be scanning every box to identify stockpiling, and you could simply get round that by not scanning...

David Moore, Locum pharmacist

Most pharmacies would get their supplier from a reputable wholesaler. And the dodgy ones? Are they going to scan their purchases?

Robin Davies,

Can you identify any “dodgy” wholesaler?


Leon The Apothecary, Student

Do you dare insinuate that perhaps, FMD, is a total waste of time? But in seriousness, why wasn't the decision made to implement FMD at the wholesaler level, it makes far more sense, I'm genuinely asking if there's a particular reason why this wasn't considered the superior choice?

Dodo pharmacist, Community pharmacist

The wholesalers refused to do it because they said it would cost them too much money and time so it got pushed onto community pharmacy 

Oliver Staunton, Information Technology

Wholesalers do scan packs, but generally not as much as pharmacies will have to!

Robin Davies,

. . . only when they are not registered as an "authorised distributor" by the marketing authorisation holder . . . this covers the vast majority of product purchased.

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