| · Anticoagulation services
· RFID tagging
· Repeat dispensing (2)
· Council election (5)
· PI insurance (2)
· Generics
· Prescription charges
· Medicines for children
· The Society
· CPD
· The register (2)
· The Journal (2)
Letters to the Editor
|
Repeat dispensing
Already agreed as an essential service
From Mrs S. Smith, MRPharmS
In both his Broad spectrum article (PJ, 26 February, p232) and his subsequent
letter (PJ, 19 March, p336), John Wilson seems to have confused the problems
with the introduction of electronic transmission of prescriptions (ETP)
via the National Programme for IT (NPfIT) with those that arose on GP
clinical systems, such as EMIS, during the early implementation of repeat
dispensing in first-wave pathfinder sites.
I believe this ought to be clarified, as his suggestions for photocopying
prescriptions may confuse some readers (although they were undoubtedly
well-intended, with patient benefit and waste reduction in mind).
Repeat dispensing and ETP are not inherently linked; repeat dispensing
can be implemented as a paper-based system, without ETP being in place.
In the future it is envisaged that the two systems will run together,
but the delay in ETP need not prevent primary care trusts from implementing
paper-based repeat dispensing systems now.
Most of the repeat dispensing software problems with GP clinical systems,
experienced by many first-wave pathfinder sites, have now been rectified.
As a second-wave repeat dispensing pathfinder site, Northamptonshire
Heartlands Primary Care Trust now has at least 1,000 patients benefiting
from the paper-based repeat dispensing system, with this number growing
daily. Many other pathfinder PCTs have made similar or better progress.
The necessary regulations, processes and paperwork are already established;
there is no need to “invent” a new system involving photocopying,
stamping and signing copies, etc.
From 1 April, as “Essential Service 2” under the new pharmacy
contract, all PCTs will be able to implement repeat dispensing and all
community pharmacists in England were recently sent the Centre for Pharmacy
Postgraduate Education training manual. There will be no need for the
Pharmaceutical Services Negotiating Committee to “negotiate an
additional payment”, as suggested by Mr Wilson; this has already
been agreed as an essential service payment under the contract.
Sue Smith
Head of Prescribing and Pharmacy Policy, Northamptonshire Heartlands
Primary Care Trust
A warning from NZ about bean-counters
From Mr D. R. Sullivan, MRPharmS
John Wilson’s suggestion for how a repeat dispensing system could
work in lieu of electronic prescription transfer (PJ, 26 February, p232)
sounds similar to the excellent repeat dispensing system that New Zealand
once had. For most patients taking medicines regularly, the GP would
prescribe in three-monthly amounts, and the pharmacist would dispense
in monthly instalments. The GP’s workload was lower and pharmacists
had an excellent opportunity to demonstrate how they could be of benefit
in managing patients’ medication.
However, a word of warning: the bean-counters will always be looking
for how to reduce costs further. Two years ago Pharmac (the NZ government
agency in charge of controlling medication costs) decided that paying
pharmacists three dispensing fees per prescription was too expensive.
The repeat dispensing option was, therefore, effectively removed for
most medicines and most patients now receive three months’ worth
of their medicines at once. The risks to patient safety and of wastage
were ignored and the change had disastrous implications for many small
pharmacies reliant on dispensing income, in some cases forcing pharmacies
to close down.
Pharmacists wishing to pursue repeat dispensing in the UK must, therefore,
ensure that the role they play in managing patient medication as part
of the repeat dispensing process is recognised and valued by those controlling
the purse strings, or else risk further erosion of their dispensing income
and professional role.
Daniel Sullivan
Auckland, New Zealand
|
The
Pharmaceutical Journal