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Will introducing Safer Shortage Protocols save us all?

By Dr Livingstone
GP blogger

18 Oct 2019

Its a plus that pharmacists be able to use their common sense to save patients from drugs shortages, says The Pharmacist’s GP blogger Dr Livingstone

OMG?! No SSRIs? Holy medicine shortages, Batman, let’s roll out the Serious Shortage Protocol (SSP)!!!!!

Yes, the SSP has come to save us all. No, it’s not the launch of a new middle ground political party to guide us through Brexit. It’s a protocol designed to ward off that other looming threat that hangs over us all – the drugs running out.

And the medication of the moment is fluoxetine, a shortage of which the Government decided a couple of weeks ago warranted invoking the first ever SSP. This is being touted as a huge leap forward for pharmacist autonomy. And yes, it’ll probably keep the patients ticking over and save me some hassle.

On the other hand, it in effect simply requires you to change a capsule to a tablet, or divide five by two, or add 20 and 10, or multiply 20 by two (2.5, 30 and 40, if you’re struggling.). Frankly, I’m not sure that really requires four years of training at pharmacy school. In fact, I can’t see why you aren’t given the leeway to exercise your common sense, discretion and mathematical skills whenever required, for whatever drug shortage, without requiring some officially stamped decree from NHS England giving you permission.

And while you’re ‘exercising your professional skill and judgement’ to establish whether the supply is ‘reasonable and appropriate’ – duh, like, when wouldn’t it be? – I, as the patient’s GP, am being instructed by the Department of Health and Social Care to contact all my patients on fluoxetine to check their supply status.

And then to discourage them from ordering their prescriptions early, presumably back-pedalling my way out of that conversation by explaining that this was just a routine courtesy call, which is not easy when you’ve just stoked up panic in a patient being treated for generalised anxiety disorder.

Which leads me to wonder how people who organise this sort of mess would feel were it their medicines thus affected by shortages.

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