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Xrayser: Why has the NHS forgotten about pharmacies’ convenience?

"No wonder we’re the third most valued business when we always make things convenient"

The health service needs reminding of one of the greatest values pharmacies offer their patients, says Xrayser

I was reading the NHS Principles this week and, as you’d expect, they are full of words like ‘respect’, ‘dignity’ and ‘compassion’. There's also “working together”, “quality of care” and “improving lives” – all phrases that chime with the professional standards expected of a caring profession such as pharmacy. But at no point in over 1,000 words of the “principles and values that guide the NHS” is there that great pharmacy word: “convenience”. Strange, because that is a “thing” in pharmacy – patients expect us to be convenient.

It’s no wonder we’re the third most valued high street business when we always try to make things convenient for patients. We order their script, sometimes before they even need it, and then deliver it to them. If they can’t be arsed to remember what they’ve taken, we push their tablets out of foil and seal them in a plastic box with days of the week on it. We order in their favourite brand of tablets and give them Ventolin for generic salbutamol. We provide their flu jab in a more convenient location and when they’ve got carried away by the moment, we are a convenient place to get emergency hormonal contraception. But most convenient of all, when they let themselves or someone they’re supposed to be caring for run out of medication, we conveniently loan them a strip – or so it seems.

Ah, the joys of emergency supply. On the one hand a surprisingly trusting nod by the Medicines Act towards our professional competence and judgement of when it is in a patient’s best interest to make a supply of prescription drugs without a doctor’s authorisation. On the other, an interminably irritating grey area that leaves patients with an expectation that it’s at the whim of the pharmacist to chuck a box their way and knock it off the script when it eventually arrives. 

Trying to explain the actual emergency supply regulations to a patient is like holding a tennis ball while trying to explain aerodynamics to your dog. They hear the words but nothing’s going in, and they just stand there looking at you blankly until they get thrown what they want. 

Of course, when we don’t make it convenient, when we won’t just loan a couple of tablets “like the other pharmacist always does”, we not infrequently get the response: “Oh well then, it’ll be your fault when I die!”

In any other circumstance I would come around from behind the counter and frog-march them out the door shouting: “You arrogant, lazy, incompetent, pathetic excuse for a patient – it’s 10.30am on a weekday so just go to the surgery and get the prescription you so desperately need and get your life sorted out at the same time!”

Except, of course, that I don’t. I conveniently tell myself that they’re ill, or frightened, or have care needs, and so excuse such childishness by an otherwise healthy, articulate adult. But, conveniently for me, I get to decide they sure as hell don’t get that emergency supply.

7 Comments

We’re all doomed, Locum pharmacist

I believe you will find that the MEP suggests that just because surgeries are open this should not prevent a pharmacist from considering an ES. 

David Moore, Locum pharmacist

Yep. Things we do for our patients. Surprised we don't actually swallow the bloody tablets for them.

Peter Sainsburys, Community pharmacist

An emergency supply is basically a private sale between you and the patient. It must be charged because otherwise your pharmacy would lose that stock. It also acts as a deterrent. The reasons must be documented, and docking it off the next script would be a loan which is illegal. What if the doctor changes the dose on the next script and something happens to the patient? You have potentially gotten yourself into a lot of trouble.

But, again, explaining this to patients is like talking to a brick wall.

Great article.

Ben Merriman, Community pharmacist

If only there was some sort of national direction that allows a group of patients access to an urgent supply of repeat medicines and appliances free of charge when they were needed [sighs and looks north...] http://www.communitypharmacy.scot.nhs.uk/documents/unscheduled_care/Section_10_Step_by_Step_Guide_version_12_Final.pdf

We've got NUMSAS if you've got a few spare hours to do the paperwork 

C A, Community pharmacist

That also requires the patient to be bothered to phone 111...

N patel , Non Pharmacist Branch Manager

About time the freebies stopped...not going ro happen any rime soon though
Try charging a patient for an emergency supply and see the fireworks start

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