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Letters to the Editor
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National Health Service (NHS)
Patient-centred care can be dramatically responsive
From Mr D. A. J. Skinner, MRPharmS, and others
We write in support of the excellent letter from George
Mileusnic (PJ,
17 February, p188) regarding patient-centred individual care and the view
of Community Pharmacy Wales advice on seven-day
prescriptions (PJ, 20 January,
p67).
We, too, are disappointed with CPW’s view that seven-day prescriptions
might be fraudulent. Might we not expect CPW to find out the facts before
pronouncing publicly? If its research shows the law to be unclear might
we not expect a more evenly balanced statement? Its current statement implies
that seven-day prescription practice might also demonstrate probity. Therefore
as we are all innocent until proven guilty there is no justification in
changing current practice until the legal position is clear.
However it is not the payment method that is important; it is the service
that is described — a service without a formal title and without
legal definition and largely invisible to the NHS, and a service that is
not just domiciliary but, together with medicines management and weekly
delivery, can form part of a care plan which is vital to the wellbeing
of disabled patients. Frequently patients are returned home from a nursing
home or hospital with revised medication and patient-centred individual
care allows carers and relatives to keep them living at home instead of
spending their lives in more specialised and expensive care. These patients
are frequently among the 20 per cent that cause 80 per cent of the work
in medical practices and this work is largely removed. The cost savings
have been effectively detailed in the previous letter; just one hospital
admission saved per pharmacy per year more than covers the costs of the
service.
That is not all. Patient-centred individual care can be dramatically responsive.
Today’s example brought the patient’s carer to the pharmacy.
He had discussed his mother’s discharge situation with her GP who
was reported to be sympathetic to this monitored dosage unit-based service.
The promised prescription arrived in the afternoon and on the following
day, when she was discharged from hospital, her medicines were ready at
home packed in MDUs.
We are three community pharmacists at different locations providing a service
similar to that of Mr Mileusnic. Together we have over 50 years’ experience
and believe that we understand the requirements of an effective patient-centred
individual care service. If this service is not to be funded by seven-day
prescriptions then we would encourage primary care trusts to put an enhanced
service in place, to study the service description outlined, to understand
how right it is, and to make their plans according to these principles.
David Skinner
Pevensey, East Sussex
Laurence Sprey
Ashton’s Pharmacy, Brighton
Mark Wilkinson
General Manager, S. G. Court Ltd |
The
Pharmaceutical Journal