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· Professional regulation
· Code of Ethics (2)
· The profession (4)
· Community pharmacy (2)
· Multiples
· Accuracy checking
· CPPE (3)
· Medicines use review
· Emergency supplies (2)
· Controlled Drugs
· NHS
· Nutrition
· Fellowship
· The Council
· Retention fees
· Section 60 Order
Letters to the Editor
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Emergency supplies
I will not be bullied into handing over medicines
From Mr R. A. Peskett, MRPharmS
I am sorry that Jim
Smith had to resort to “an unpleasant — and
public — argument” in order to obtain a salbutamol inhaler
from a pharmacy when his wife ran short of the medicine (PJ, 1 July,
p11).
Some years ago, it had become apparent that a growing number of local
patients were managing their condition entirely by emergency supply,
without any medical intervention. On speaking to GPs it became clear
that patients were not using preventive medication, and had deteriorating
conditions.
I made a decision at that time not to provide emergency supplies of salbutamol
inhalers to patients for whom I had no medication records without first
contacting their GP. Implementing this policy has never presented insurmountable
hurdles to resolving situations calmly.
Conversely we have seen positive results through helping patients who
use a primary care trust repeat dispensing scheme; a number of them have
been enabled to control their conditions with increasing success.
So I am sorry Professor Smith, but your technique would not work with
me. I will continue to work with patients to seek maximum benefit from
treatment, rather than be bullied into handing over medicines, whether
prescription only or pharmacy medicines, on demand.
Rupert Peskett
Reading, Berkshire
Pharmacists should seize the opportunity
From Mr N. Heslop, MRPharmS, and Mr A. Todd, MRPharmS
We, too, share the concerns of Paul
Burgess (PJ, 24 June, p747) and
Jim Smith (PJ, 1 July, p11) regarding the emergency supply of salbutamol
inhalers. We would, however, extend our concerns beyond that of the reclassification
of salbutamol to the provision of emergency supply in general. Reclassification
should not be necessary.
Provision is made within the Medicines Act 1968 and the Royal Pharmaceutical
Society’s Code of Ethics for the supply of prescription medicines
at the request of a patient in cases where there is an immediate need
for the POM and where it is impracticable to obtain a prescription without
undue delay. Indeed, the Code of Ethics is most specific: “Pharmacists
must consider using their rights to make emergency supplies of medicines
whenever a patient is in urgent need for a medicine. They must consider
the medical consequences, if any, of not supplying. Where pharmacists
are not able to make an emergency supply of a medicine they should do
everything possible to advise the patient how to obtain essential medical
care.”
Confusion and misinformation seem to abound surrounding this advice.
Many seem (possibly as a result of anecdotal, historical belief, or badly
interpreted corporate guidance) to translate this as:
· Emergency supplies must not be done if GP surgeries are open or an
accident and emergency department is nearby.
· Patients should not be given emergency supplies unless they have “evidence” on
their person, such as a repeat slip or empty box, or at least be a regular
customer and recorded on the pharmacy patient. medication record system
· Doing an emergency supply will encourage patients to “forget” to
go to the doctor and request to “borrow” tablets from the
pharmacist on a regular basis.
There also seems to be reluctance by some to provide emergency supplies
because they do not wish to take the necessary professional responsibility.
The meaning of “an emergency” is open to interpretation,
but we would urge our colleagues to view a pharmaceutical emergency as
an entirely different situation from that of a medical emergency. The
patient should not need to be at death’s door to encourage a pharmacist
to act.
It is of course, the duty of the individual pharmacist present to make
the important decision of whether or not an emergency supply should be
provided. We both have personal experiences of pharmacists who have supplied
in an emergency and done a most excellent job.
We would urge all pharmacists to seize this professional opportunity
and act in the interests of patients and other members of the public.
Pharmacists should be inclined to grant emergency supplies whenever it
is possible to do so. Refusal should be for sound legal, ethical or clinical
reasons only. Pharmacists should not hide behind one-size-fits-all corporate
guidelines. Patients are individuals and should always be considered
as such.
Neil Heslop
Adam Todd
Sunderland Pharmacy School,
University of Sunderland
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The
Pharmaceutical Journal