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Letters to the Editor
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Shambolic procedures
Penalty for providing unpaid services
From Mr A. R. Korsner, MRPharmS
It was tragic to read of a pharmacist being struck off for the crime
of providing, what are often, unpaid NHS services. (“Shambolic” procedures
lead to striking-off, PJ 19 April 2008, p487). It never has
been possible or made economic sense to provide a compliance aid service
for
free.
This is clearly not a service to offer lightly and not one to be underestimated.
To allot the time and space required and take the associated risks requires
that a, not unsubstantial, fee be attached to the service.
When I did costings on behalf of several local pharmaceutical committees in
2004 it became clear that only by receiving a fee of about £200 for assessment
and set-up costs and £400 per patient per year would a professional service
be viable.
It was difficult to convince pharmacists of the need to spend adequate time
in setting up and keeping the paperwork up to date and the dangers of just
muddling through.
On the basis that you get what you pay for (and I do not know whether this
particular pharmacist was receiving a payment from his primary care trust,
but I will wager it was not as calculated as above) I am deeply saddened for
the pharmacist concerned, but not surprised.
I am fortunate to be in the position of offering this service to my elderly
mother. By the time I have checked the prescriptions, popped the medicines
out of the foils, filled up the Dosette box and checked each compartment for “jumpers” the
best part of an hour has passed.
What kudos or appreciation does the profession gain from being seen to have
been involved in such a case and how can it be expected to be taken seriously
in this and other ways?
The latest professional innovations seem to be taking us towards being GPs’ assistants
(second class) instead of professionals in our own right. In my thoughts this
is because we are not funded properly (less than £1 professional fee
for a prescription, with all its responsibilities) and thus corners are inevitably
cut. Only if we receive viable calculated fees for services should they be
done.
I realise this may be seen as a retrograde step, but anyone working at the
coal face will know how official “extended services” have impacted
on their income so what is the point? My experience is that the word “shambolic” best
describes many service payments from PCTs, like minor ailments. Even if we
get them we can rarely check them against our submissions and we just have
to trust to luck. If we are underpaid, tough luck, but if we overclaim, we
are in trouble.
As a profession we should stop the infighting and rivalry, stop offering incentives
for professional activities (free collections and delivery) and we just might
regain the professional pride we had 20 odd years ago.
Adrian Korsner
London |
The
Pharmaceutical Journal