I'm a dispenser in a community pharmacy: AMA

[CaptainCallisto]

People always pepper me with questions when they find out what I do, so I thought it might be a good AMA. Of course I could just have weird friends

do you report side effects to the yellow card when chstomers/patients mention them to you?

What action is taken if something is wrongly dispensed, my DH was given the wrong meds and I felt it was just brushed under the carpet, despite the fact it could have been very serious?

What's the hardest part of your job?

thanks btw. I have loads of questions :o

another one. we have issues with local (big chain) pharmacy which sometimes dispenses in a plain white box without pharmacy sticker or package leaflet.

surely that's not good practice!
where can we complain to?

We do usually report side effects, yes.

If something is wrongly dispensed there are procedures in place depending on the severity of the incident. It's always recorded on the patient's record, and also on a dispensing error log (details of what, when, who did it, possible cause etc). If the error was spotted before the patient used the medication then there's no further action. If the patient has taken the medication, then it is reported to their GP as well, our chief superintendent pharmacist, and if necessary the PSNC. It's certainly not brushed under the carpet where I work, though thankfully is a fairly rare occurrence!

The hardest part of the job is probably the stock shortages. Commonly used items will just disappear for months at a time, and we will spend hours each week trying to source stock, find alternatives, consult with surgeries to get prescriptions changed etc. It's bloody frustrating! Patients (understandably in a lot of cases) get upset when we can't give their medication straight away, and while in most cases they're understanding that it's not our fault and grateful for our efforts, we still receive a lot of abuse about it.

To be honest, abuse in general is a close second! I've been yelled at, sworn at, spat at, and threatened. It's just a part of the job but it's not fun to deal with!

bluerunningshoes that is definitely not good practice! It is appallingly bad practice! If I were you, I would speak to the pharmacy manager directly (take the box/boxes if you still have them). If they're not helpful then put a complaint in writing to their superintendent pharmacist. They should (by law I think) have a complaints procedure displayed somewhere that customers can see it.

How do you think Brexit will impact your job?
I know the pharmacy at my workplace are having weekly meetings.

I know the guys at the main office (we have six branches so we're not a large company) have been having meetings and putting plans in place. I'm honestly not sure how smaller businesses in particular are going to manage; the profit margins are so small after all the bloody budget cuts that a lot of independents are going under already.

If we lose access to the parallel imports from Europe the stock shortages are only going to get worse too.

I'm trying not to think about it too much!

What do you actually do when I hand in my prescription? I'm assuming it's a lot more than take a box off a shelf, stick it in a bag and put a sticker on it? Has to be given it can take over an hour in my local chemist!

Are you worried about the possible detrimental effect of Brexit on stock shortages? Is any planning in place for this?

Sorry I don’t think I worded my post very well. Are you worried about the possible detrimental effect of Brexit on stock levels? Have you been given any briefing on this and are there any preparations in place?

This is interesting!

If you're waiting for your prescription I would take it straight to the dispensary computer (or add it the the queue if we're busy) and load up your individual record. I'd check your details against the local record to ensure I've got the right 'Jane Smith', check the date on the prescription to make sure it's valid, and make sure the GP has signed it (we probably get six or seven a day that haven't been signed!).

Assuming all that is in order I would go to the shelf and get the relevant medication before I label it, because if we're missing anything it saves going back in and editing it afterwards.

I put in the details of the medication, quantity, dose etc, and check to see if you have had it before or it's a new item. If it's a repeat of medication you've had before I'd go straight to printing the labels, but if it's a new item I'd grab a sticker to let the pharmacist know it's new to you. They often want to check it against your other meds, or just make sure you're comfortable with how to take it etc.

After the labels are printed you put the prescription through the endorser so it has details of which pharmacy has dispensed it and what we have given. Then I put the labels on the boxes, double checking I've picked the right things as I go. Check the expiry dates on the tablets, and put my initial on each box. The pharmacist then double checks what I've dispensed against the prescription, put their initial in each box next to mine, and bags it up.

Most prescriptions are in and out in less than five minutes, but there are some that either have huge amounts or come in different quantities than standard which can take a bit longer. We have one gentleman who gets fifteen items a month, most of which have unusual quantities (if it comes in a box of 30 he needs 28 and vice versa) and includes some controlled drugs. He insists on sitting and waiting for it every time, and it takes about 25 minutes to get it done, which means anyone that comes in after him has to wait.

We do always let people know when they hand in their script how long the wait will be so they can choose whether to wait or leave it with us and collect later.

Sar51 I'm almost certain it will have a detrimental effect on stock, as often all we can get is the imported stock. I haven't seen a uk manufactured box of some medication for years! I am sure the business has plans in place, though as yet I haven't had any sort of briefing on it. It is a definite worry though!

I have one on paediatric formulations.
dc needed a medicine commonly used in adults. only available as tablets in uk. pharmacy quoted us a ridiculous amount to make up a liquid formulation (private prescription)
googling turned out a liquid formulation is available in another eu country costing as much as calpol.
can you import such medicines?

You can, but not on an individual pharmacy level. We'd have to get it through a wholesaler, or a specials manufacturer. If the medication wasn't available in that form in the uk, like yours, it would have to come through specials. The likelihood is that it wouldn't be in the drug tariff (which essentially lists what is prescribable and what you will be reimbursed by the NHS) and would be unlicensed, so it would have to be either imported from abroad or specially made up for you. This costs a bucket load! We have one child who needs a particular enema, that is only manufactured in the US, and his prescription costs £2400 every month. Luckily for him it's an NHS prescription so they don't have to pay anything!

Thank you for answering me :) it's a far more in-depth process than I assumed with a lot more checks. That's reassuring!