| · Oxygen supplies (5)
· Community pharmacy
· Vitamin D
· Care homes
· Boots/UniChem merger
· Locum pharmacy
· Assisted dying
· Methadone
· Statins
· CPD
· Criminal convictions
· Overseas pharmacists
· National boards
Letters to the Editor
|
Oxygen supplies
Surprised by comments
From Mrs B. E. Bevan, MRPharmS
I was surprised by the letters (PJ, 18 February, p204) regarding the
non-action by some primary care trusts with regard to the oxygen supplier
changeover. My team and I joke that we have “lived and breathed” oxygen
over the past four months. The scenario goes something like this:
· In October 2005 we wrote to all GPs and community pharmacists asking
for details of their oxygen patients. This information was put into a
database, which highlighted a large number of discrepancies. We then
spent a good deal of time on the telephone to the GPs and pharmacists
to sort out these discrepancies.
· We set up a project group, which included local hospital staff and
a representative from Air Products, to devise a workplan for the transition.
· In November we wrote to every oxygen patient explaining the changeover
and requesting their permission to hand over their data to the new supplier.
This resulted in numerous telephones calls from concerned patients and
carers.
· We then wrote individually to all the GPs of the patients who had not
responded, asking for their help to obtain the patient’s consent.
· A detailed letter was sent out in January to GPs, community pharmacists,
and all PCT staff explaining the practical steps necessary for implementing
the scheme.
· On 3 February we received a telephone call from Air Products explaining
that it had been completely overrun over the weekend and that FP10s were
being reinstated. It had faxed all GPs to this effect. We then faxed
and posted first class this information to our community pharmacists.
Over the past two weeks my team has fielded up to four telephone calls
a day from worried or angry patients, confused GPs and one hospital registrar.
As far as we are aware these problems were all resolved with no detriment
to any patient.
All this, of course, has been undertaken with no extra resource for my
team and has had to be fitted in around our usual workload. I would like
to add that every contractor we contacted for help did so willingly and
cheerfully, which certainly lightened our load.
Beryl Bevan
Chief Pharmacist
Ealing Primary Care Trust
A disaster of the Department of Health's own creation
From Mr R. J. S. Hazlehurst, MRPharmS
Jeanette Howe’s thanks to community pharmacists (PJ, 18 February,
p204) for their support during the oxygen crisis seem hollow to say the
least, and only add insult to injury.
My grandfather told of a menial worker who, having performed a small
favour for the squire’s lady, received a haughty “Thank you,
my man” by way of appreciation. “Ay, missus,” he replied, “me
pocket’s full o’ thanks.”
Ms Howe’s thanks would be more meaningful had they been accompanied
by a tangible gesture of appreciation. She could have suggested a substantial
increase in the dispensing fee for oxygen or the payment of a sizeable
lump sum, either of which could be made through the Prescription Pricing
Authority and would not involve primary care trusts. And an agreement,
after all, to help community pharmacists out of the lost cylinders crisis
would be a fair return for community pharmacists helping the Department
of Health out of the new supply crisis.
Instead, the possibility of any recompense was passed to PCTs and local
pharmaceutical committees to negotiate under urgent and stressful circumstances,
with the risk of causing damage to local relationships at just the time
that we should all be working to improve them.
Ms Howe’s statement sought (in vain) to put a good spin on a disaster
of the department’s own creation. Certainly, the new oxygen service
providers got it all wrong, and community pharmacy is picking up the
pieces. But let us not overlook the fact that the new providers quoted
to a specification provided by the department, written in an ivory tower
by someone who has, clearly, never delivered an oxygen cylinder in his
or her life. A day out of the office, shadowing a community pharmacist
providing a normal oxygen service might have prevented all this mess.
When will they ever learn?
Dick Hazlehurst
Secretary
Bradford Local Pharmaceutical Committee
An open and honest inquiry is needed
From Mrs S. Smith, MRPharmS
There are many comments that I, as the home oxygen service (HOS) lead
for my primary care trust, would like to make about the transition to
the new oxygen arrangements, most of which are not particularly complimentary
to Air Products or the Department of Health. However I would like to
focus on one point in particular.
It infuriates me to read Jeanette
Howe of the Department of Health (PJ,
18 February, p204) and Air
Products (ibid, p191) trying to imply that
this chaos in which we (patients, pharmacists, GPs and PCTs) now find
ourselves is all part of some intentional transitional plan. It is clear
from documents on the HOS section of the Primary Care Contracting website
that the only “plan” in place for a “transition period” was
the fact that any FP10s issued on or before 31 January would be valid
until 31 July at the latest, ie, the normal six-month validity of an
FP10. There was never any suggestion that FP10s should be written or
dispensed for oxygen after 1 February and for the DoH and Air Products
to suggest otherwise is a distortion of the facts.
Once the dust has settled and the service for patients is up and running
properly under the new contractors, there should be an open and honest
inquiry by the DoH into this fiasco. I hope this is not the first hint
of a cover-up.
Sue Smith
Head of Prescribing and Pharmacy Policy
Northamptonshire Heartlands Primary Care Trust
If it works, why fix it?
From Mr D. S. Badham, MRPharmS
I believe the decision to change the supply of domiciliary oxygen from
community pharmacy to a new supplier is a serious mistake by the Department
of Health.
From events in the past couple of weeks we have seen a well-tuned operation
turn into chaos. Clearly the delivery service offered from the suppliers
is no match for that provided by a health care professional.
Although it could be argued these flaws are temporary, I have serious
reservations that, without the expertise of community pharmacists, lives
have been and will be put at risk unless the department revisits the
supply of oxygen.
Interestingly, the recent publication “Our health, our care our
say” makes great play of bringing care to the community, easy assesses
to services and patient choice. Why is it then not possible for primary
care trusts and patients to choose their own suppliers?
As a second generation contractor who has supplied oxygen since I was
knee high to a grass hopper helping my father carry the cylinders, I
think our profession should be congratulated on saving the day.
David Badham
Ethical Director
Badham Pharmacy,
Cheltenham, Gloucestershire
Out of chaos came order
From Mr P. R. Breame, MRPharmS
I have read with interest the comments, complaints, gripes and snipes
from correspondents and companies alike over the past few weeks relating
to the oxygen fiasco. I feel that it is time to put forward a view from
someone working for an organisation “caught” in the middle
of all this — a primary care trust. I hasten to add that this is
my personal view and not that of my PCT.
PCTs were tasked, whether or not they agreed with the changes to the
service, with ensuring that the new providers were given all current
oxygen patients’ names by 6 January. The exercise began in November,
starting from scratch, trying to collate information held by community
pharmacies, GP services and contractor services. Once this was done,
letters had to be written to patients seeking consent to send their details
to the provider — all to be completed while the “silly season” for
the Royal Mail was going on. This was an enormous task as a great deal
of the information did not match up and, I believe, in some areas not
all professionals were prepared to co-operate. PCTs were not given additional
staff to carry out this exercise — it had to be fitted in beside
everything else. Believe me, it was not easy.
The new providers then had less than a month to “get their act
together” before the new service started. PCTs and GPs alike were
given conflicting advice on when to send in HOOFs (home oxygen order
forms), community pharmacies began to run down cylinder stocks in anticipation
of the change and there was confusion over the validity of FP10s. None
of these helped in providing a smooth transition —
and patients were in danger of being caught in the middle. Frankly, I
was terrified of what would happen on 1 February.
Now the date has come and gone and my worst fears did not materialise.
Why? Because I had excellent co-operation from community pharmacies and
surgeries locally, I tried to keep everybody informed all the time of
the situation and both pharmacists and surgeries worked together to ensure
patients did not suffer. The workload for everybody was enormous. Yes,
there were delays in patients receiving deliveries but pharmacists kept
them supplied. No patient suffered and, to date, nobody had to go to
accident and emergency as a result of the change.
When the dust has settled and the changeover is evaluated, I hope that
the Department of Health will reflect on whether it was a good idea to
change a service at the busiest time of the year, if at all. I am sure
that lessons have been learnt. Community pharmacists have provided an
excellent oxygen service over many years, but with antiquated equipment.
I believe many will agree that they would not have been able to move
this forward into the 21st century, providing patients with the hi-tech
equipment that is now required. I would wish to see adequate compensation
for decommissioning headsets as some recognition for the past service,
but that is in the hands of others.
So let us stop the sniping, work together to smooth the transition and
get on with doing what we, as pharmacists, do best — looking after
patients.
Paul Breame
Frinton-on-Sea, Essex
|
The
Pharmaceutical Journal