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Letters to the Editor
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NHS
What is wrong with patient-centred, individual care?
From Mr G. Mileusnic, MRPharmS
Having read the item regarding the Community
Pharmacy Wales advice on seven-day prescriptions, which includes the words “colluding” and “fraud” (PJ,
20 January, p67), it makes me wonder yet again about the actual point
of the NHS and in particular community pharmacy.
How the word “fraud” can be used for issuing seven-day prescriptions
instead of one 28-day prescription evades me. How the work of collecting,
dispensing four times, and delivering four seven-day prescriptions can
be construed as non-NHS work also evades me. Surely the whole point is
that this is delivering the best care by the GP and pharmacy.
Working closely with GPs, district nurses and social services, I have
carried out this practice for a number of years. The real benefits to
patients are clear for anyone who cares to be involved. Yes, “real
benefits to patients”. I do realise this seems to be an old fashioned
way of looking at health care but it is the way it should be viewed.
Compliance is checked weekly, as is the health of the patient, since
the same trained member of staff goes each week. This is patient care.
To address what is clearly the most important issue to bureaucrats, namely
money, the benefits are so obvious I think perhaps I am the one missing
something. When a monitored dosage system is started several carrier
bags of medicines are removed from patients’ houses. Vast amounts
of stockpiled medicines in their original dispensing bags are collected.
Patient compliance is clearly almost nil. Huge amounts of NHS funds are
wasted daily in over-prescribed medicines. People stockpile — that
is a fact. If they only receive one week’s supply each week, stockpiling
ends, immediately saving large amounts of money and time in prescribing
and issuing unnecessary prescriptions. The health of patients usually
improves since compliance improves. Hospital admissions decrease for
the same reasons.
We notify GPs and district nurses if problems with patients occur since
we know our patients and work together with colleagues. Take, say, a
three-item prescription. Yes, we get three fees, but for this we supply
the MDS, fill it, check it, deliver it, check compliance, talk to the
patient and, if necessary, discuss their case with colleagues. Is this
not clinical governance?
So how does this service not seem effective? How can it be described
as fraud? The savings in stockpiled medicines alone will pay for this
service many times over.
Patient-centred individual care. What is wrong with that?
George Mileusnic
Batley, West Yorkshire
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The
Pharmaceutical Journal