Martin Hao, managing director at Healthera , questions the damage the new repeat prescribing model is having on community pharmacies
A controversial Clinical Commissioning Group (CCG) scheme that is banning some pharmacies from managing their patients’ repeat prescriptions has divided opinion in the sector.
While there are clear benefits of the scheme, and parts of it have managed to save the NHS money, it is clear to see that the negative impact on pharmacies has not been properly considered and the – more significant – underlying factors behind the issue itself have been overshadowed by statements of blame.
The picture painted by CCGs that are backing the repeat prescription scheme is simply that UK pharmacies are purposely or inefficiently over-ordering patient prescriptions in order to boost their dispensing income.
While this may be true for a select few pharmacies, it seems wrong to tarnish every chemist in the UK with the same brush. In fact, to state so resolutely that pharmacies are commonly wasting resources paints all community pharmacies in the same negative light despite the fact there simply isn’t evidence that this is commonplace.
Think about the process before repeat prescription schemes. Patients would go to their local pharmacy to order their medicines and these orders would then make their way to GP practices in large batches – a process which relieved pressures on both GPs, pharmacies and patients alike.
Effectively, the new repeat prescription scheme has now increased the workload for GPs and has been proven to make simply ordering a repeat prescription confusing and difficult for patients, especially those who have busy lifestyles or are of an older demographic and suffering from issues such as dementia.
The pharmacy, medical practice and patient struggle caused by the new scheme in already affected areas is obvious, and the impact has no doubt been accentuated by a lack of consultation with pharmacies from their respective CCGs.
A scheme of this magnitude surely demands input and feedback from all parties involved. And this oversight has resulted in sour feelings and a significant step back in terms of collaboration progress between the organisations which help ensure patient safety and service delivery in a cost-effective manner.
The bottom line is that this new scheme cuts pharmacies out of the loop, it negatively affects their business and also causes numerous problems for patients and for their GP practices.
I agree- if pharmacies have no idea when patients ordered their prescription or what they have ordered, how are we supposed to know if all the items have arrived, if the correct items have been issued by the surgery, whether the patient is collecting or wants a delivery, we don't have chance to order any special stock in, and we are only able to tell the patient "I don't know, it's nothing to do with us any more" when there are queries about the prescription. I can see why the money saving aspect is appealing to CCGs, but I'm quite sure that everywhere I've worked we didn't just randomly order everything for patients as we were far too busy. When someone phoned in for a repeat we would ask them what they wanted to order, and insisted that we go through the items if they said "everything". I still read the items to them and asked them if they needed each one. Never used managed repeats, so can't comment on that.
I've just been to a Meds Optimisation meeting this week and part of the discussions was around one of these CCG POD (prescription ordering direct) schemes, and said the same things to them as above. The Meds Opt people realised that having some information for pharmacies would be helpful and they may build in asking the patient if they are collecting or want a delivery and they said they can add that to the pharmacy messages section of the prescription. It's a start I suppose! I'm sceptical of the schemes for all the reasons above.
I totally agree. We practice exactly the same policy when taking orders from our patients . Even when they ask for everything, we go one by one, and very often the patient would say, that they have enough of certain items and hence not all the items would be ordered. This has been time consuming, but better for the NHS.
It's the multiple's and larger chains that have used the automatic reordered scheme , which has tarnished the reputation of all pharmacies.
We even invested in our own website to take repeats on behalf of patients , again no over ordering or automatic, and fully auditable.