The Pharmaceutical Services Negotiating Committee seems to have set its face against the use of algorithms in counter-prescribing. It has taken this stance in response to an approach from the Royal Pharmaceutical Society on the subject (see p280). Algorithms, the PSNC suggests, could lead to robotic responses to patients. But in arriving at its position, the PSNC seems to have got hold of the wrong end of the stick. The approach from the Society was not, as the PSNC would have us believe, to propose that rigid algorithms be introduced. Rather, it was an information gathering exercise.
As a result of discussion within the Practice Committee, the Society is in the process of seeking examples of algorithms which would support a considered approach to counter-prescribing. It has written to a number of bodies seeking such information. Furthermore, the Society has made it clear that it is not interested in excessively prescriptive devices but ones that allow appropriate professional discretion.
One thing that needs to be borne in mind, of course, is that algorithms are designed to encourage a logical, step-wise approach to problem solving - in this instance, responding to symptoms presented by individual patients. Surely there can be nothing wrong with that. There is more likely to be a consistently high standard of service in community pharmacies if problem solving is sensitively structured rather than dealt with on the random basis that the PSNC seems to prefer.
In any case, the PSNC is swimming against the tide. The demands of good clinical governance are leading to the development of guidelines of one sort or another in all walks of professional life.