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Letters to the Editor
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Community pharmacy
Disastrous Christmas rota
From Mr N. Baumber, FRPharmS
The Christmas Day 2007 rota was a farce. The Yuletide rota can be really
busy and I have seen queues out of the door, down the road and around
the corner when influenza coincided with my turn on duty.
For 13 years
I organised an orderly but fair and flexible rota in the town. Now we
have a 100-hour pharmacy, no weekly rota and a primary care trust that
has been given responsibility for out-of hours (OOH) services.
First through the door this Christmas was a prescription from the OOH
service: calamine lotion OP; hydrocortisone cream 0.1 per cent 50–100ml.
There were no directions, questionable quantities and little evidence
that the prescriber knew what had been prescribed previously for this
patient.
The modern OOH service has no access to surgery records (unlike
the days when GPs from each practice covered its own patients at night,
weekends and bank holidays). Having sorted that out with the parent and
the prescriber, the prescription had to be sent back to the local hospital
in search of the locum in the hope that it would eventually return in
a satisfactory condition.
Next, a dental prescription arrived from Peterborough, nearly 40 miles
away. Was there no one else open north of Watford, I wondered? Thankfully,
it was an item included in the Dental Formulary.
Third was a man bearing an empty blister of Zofran Melts 4mg. He had
been sent along by the OOH service without a prescription to see what
we could give him for his father. This patient had been discharged from
radiotherapy with five tablets, and had run short. I had a bottle of
Zofran syrup 4mg/5ml on the shelf so rang the duty doctor to get his
assent to the supply. He had left the OOH surgery. I finally traced him
on a mobile telephone at the patient’s house.That prescription
might turn up in the New Year, and then again it might not.
After that problem had been resolved we might as well have gone home,
but I used the time to explore the medicines use review facility on the
patient medication record computer. Net result: two forms, one item,
three promises (potential net loss about £70).
Where had the public gone? The answer to that was simple. On Christmas
Eve a member of staff rang me to say she had just passed a well known
high street pharmacy where it said on the door “If we are closed,
ASDA will be open”. Actually ASDA was closed on Christmas Day and
Boxing Day. The Christmas message had gone astray.
The intended rota notice for the county actually arrived by
e-mail on 19 December, by courtesy of our efficient local pharmaceutical
committee secretary. Apparently the PCT had arranged three different
pharmacies to do the local end-of-year rota.
Confusion reigned since
all three had been invited to open on the same day, Boxing Day. On the
Friday before Christmas the PCT rang me to see if the only independent
in town would do both 25 December and New Year’s Day. It is hardly
surprising that the public did not know where to go.
It frightens me that the Government is so confident that the pharmacy
contract can be devolved to PCTs that it did not even bother with an
impact assessment. Maybe, as with oxygen, patients will make their own
assessment. Noel Baumber
Grantham, Lincolnshire
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The
Pharmaceutical Journal