One size will not fit all
When pharmacists were first given the go-ahead to offer repeat dispensing services, the plans were heralded as one way to allow patients easier access to health care, particularly in primary care. The Department of Health and the Pharmaceutical Services Negotiating Committee are firmly committed to repeat dispensing by pharmacists and see it as a central service in the future (p559). This week's cover story (p567), however, suggests that establishing repeat dispensing schemes nationally may not be as straightforward, or as welcome, as first envisaged.
In the longer term, it should be relatively easy to sort out some of
the practical difficulties. The problems with software used in GP surgeries
that caused some months’ delay in enabling the pathfinder site
schemes to start are surmountable. Similarly, better IT systems for community
pharmacies should be installed in the next five years and make repeat
dispensing administratively simple.
Primary care trusts have found it hard to encourage some GPs in pilot
areas to come aboard. This is either because they already have reasonably
efficient repeat prescribing systems in place, or because they have been
so consumed by understanding their own new contract that they have not
wished to become involved in yet another Government initiative. This
reluctance should change in time as more GPs appreciate the benefits
to them in reducing the workload associated with repeat prescribing and
they become confident that patients will be more closely monitored than
at present.
The unknown factor in the uptake of repeat dispensing is patients themselves.
In the early years of the Labour administration it used to be said that
Government initiatives were prompted by the personal experience of the
health policy advisers in No 10 — all young men. Certainly, it
is young professionals who would benefit from the convenience of having
their prescriptions based at a pharmacy. But how many of them are really
likely to require access to a repeat dispensing scheme?
Most people who would be eligible for repeat dispensing are chronically
ill and are likely to be in the older age groups. This week’s news
feature hints that some of these people, especially if they are isolated,
do not want to forfeit their visit to the GP surgery, as it is a social
occasion as much as a health encounter.
Repeat dispensing, therefore, may be a good thing, but it is not going
to suit all patients and it may not deliver all the benefits the Doh,
the PSNC and its other advocates hope.
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