Wtf is going on with pharmacies

[cachecache]

I remember a time when you would go to the doctor, or put a repeat prescription request in, get a green bit of paper, take it to a chemist and get your medication after a short wait.

My previous pharmacy was taking 3+ days to dispense medication so I moved to one that seemed a bit quieter.

This one is now telling me it's going to be at least 24 hours. And it's been sent electronically so unless I want a load of piss arsing about asking for it to be released and queuing up for a receipt to get it elsewhere, I just have to wait.

I have a raging infection that I need antibiotics for I can't understand why it's taking days to get medication. I don't even mind them saying come back in a couple of hours, but several days is surely taking the piss?!

@ArseInTheCoOpWindow, I wonder if your pharmacy is my mum's?

She had an op recently so I went to collect a prescription for her and it was exactly how you describe.

It has improved a bit because the woman who ran it has come back - it was a mess after she left. It is attached to the surgery.

Delays, saying they don't have things, saying they've not sent a text when they have, saying they have sent a text when they haven't.

Lack of staff may mean slow but it shouldn't mean incompetent.

It is also really annoying when medication is gatekept so you can't order it earlier than 7 days before you need it, but they take 10 days to fulfil.

We also have a pharmacy which is attached to our GP. It's not so bad, although they told my DH that he'd had collected a prescription already when he hadn't.

And OP whether you voted for Brexit is relevant because people who did, helped to cause this, so they can quit the whining. I am glad you didn't!

That said, pharmacy numbers have reduced drastically in Germany as well, so there is something else going on. It isn't just about Brexit and Tory policies.

I’m a pharmacist. I no longer work in community pharmacy (pharmacies on the high street) and have switched to a different sector recently as it’s a thankless and incredibly stressful job.

It’s very difficult reading this thread as there are certainly examples of things going wrong, like OP not being able to get her antibiotics within an hour of them being prescribed - once she had asked for them, they should have been dispensed as soon as possible.

On the other hand, there is so much that is not understood about pharmacy from the public side of the counter. Lots of people in this thread and in real life very confidently assert things about pharmacy work that is incorrect, but it’s difficult to fully appreciate the issues without working in a pharmacy or spending a long time listening to someone explain the issues.

Some major issues:

Stock availability problems, many of them long term, affecting an unprecedented number of medicines, often with no straight forward alternative, no open channel of communication to the prescribers to get the issue sorted and no legal power to substitute sensible alternatives without a specific protocol written by the government (which only lasts a few months and usually arrives months after the problem began I.e. too late!).

The sheer volume of prescriptions. My old pharmacy dispensed over 700 items per day. More prescriptions are being written than ever before, with increasingly complex drug interactions, adverse effects and other problems that need assessing and dealing with. As a pharmacist I am 50% liable legally if I let something through that harms a patient due to wrong dose etc. even if it’s exactly what the doctor wrote on the prescription. It takes time to assess prescriptions for these things and it’s not uncommon to have a prescription for more than 15 items for one person.

Pharmacy is a changing and evolving sector, and things are almost unrecognisable compared to only a few years ago due to technology and contractual changes. Pharmacies are no longer being paid just to dispense, but instead they are needing to deliver extra services to get the same pot of money that used to be there just for dispensing. The government’s stated aim is to reduce the number of pharmacies in England, and to encourage pharmacies to use robot dispensing technology, in external warehouses, that then deliver dispensed items to individual pharmacies - the hub and spoke model.

Morale is at an all time low for pharmacy staff, with burnt out staff (👋) facing an ever increasing workload and an ever more enraged public who can’t understand why it’s not like it was 20 years ago.

A fairly standard scenario in the pharmacy would be me and one dispenser at the weekend. The GP surgeries are closed and we won’t get any stock delivered until Tuesday morning. The phone is ringing, I’ve got a woman waiting to speak to me about her screaming baby, an older man with a young girl wanting to get the morning after pill (possible safeguarding issues, need to handle with great sensitivity), someone is arriving in 5 minutes to speak to me about their ear pain as referred by 111 (physical assessment, history taking, possible medicines supply and counselling, a huge write up), there are 4 people queueing to collect prescriptions, there is an antibiotic prescription waiting to be checked with an unusually high dose (but remember the GP surgery is closed so can’t call them to check and I don’t have access to the patient’s GP medical record) and someone has just handed in an urgent prescription for 6 medicines for end of life including morphine ampoules that need to be written in the controlled drug register, I need to see ID from the person collecting, plus check all the prescriptions are written legally and the doses are correct. And they need it now as the patient is actively dying.
Oh and I’m also personally responsible for every medicine sold from behind the counter even if I’m not directly involved in the sale.

If I make a mistake, I can go to prison. I’ve got no office door to hide behind, no chair to sit on to think about things carefully without distraction, no appointment system.

I would need to go on for even longer to flesh out all the various factors at play, but I will just say this: you wouldn’t like to work in a pharmacy at any point in the last 5 years.

@ChestaDroors has nailed it.

I work in hospital pharmacy now and I’d estimate that around 90% of our staff have moved from community pharmacy in the last 5 years. It’s become a pretty thankless job for all roles involved.

The issues are quite clear. A massively increased workload, poor pay (especially for dispensers & technicians; I would be lost without them!), the minimal staffing levels, the lack of understanding from the public and even prescribers about how a pharmacy actually operates, stock supply issues… The list goes on and on and on and on.

Unfortunately, it’s only going to get worse.

Christ we are in a rural county and it's 7 days before we can collect prescriptions that are sent electronically it's ridiculous

I work in a community pharmacy and it has become a different world over the past 3 years since covid. So many have closed, so much of the "easy" side of the business has gone online (though people are coming back when their medication needs become complex). It is sooooooooo busy nowadays.

We come in in the morning to 120 prescriptions waiting to be pulled off the system and made up... before we even start. There will be 3 or 4 overnight referrals by 111 to be rung and arranged to see. There will be 6 or more people come in in the morning for the pharmacist to look at under the new prescribing thing, or emergency or other contraception - takes about 15 min per patient.

The pharmacist is unavailable to check prescriptions or provide advice whilst doing that consult. It is then easy to see why everything just takes so much longer. The bottleneck is the (singular) pharmacist.

This.

I don’t know why that is happening, I’ve never had a prescription take more than 20 minutes

weird

Forgot to add - with electronic prescriptions there is little to no way to determine whether a prescription is urgent or non-urgent until the token is printed.

GPs will often release huge batches of prescriptions to the spine at a few intervals throughout the day, regardless of whether they are acute or repeat prescriptions. This might mean that your prescription for urgent antibiotics prescribed at 9:30am might not be downloaded until 1pm, along with the other 10s of prescriptions they’ve signed off that morning.

For example, 10 GPs each release a batch of prescriptions at midday. The pharmacy then have to print 200 prescription tokens and triage them into urgent and non-urgent. Except they can’t because there’s only 3 members of staff and the phone is ringing, there’s a queue a mile long, there’s 10 unread emails and 15 referrals from 111 and the delivery arrives and needs booking in!

The current state of community pharmacy is so frustrating for everyone involved.

My Gp surgery has a pharmacy attached to it. If a GP sends a prescription by electronic means my meds will be there after a 10/15 minute wait. If I’m ordering from my GP as a repeat it could vary from next day to 2 days later.

Lots of places sell them. They do 'sailor's packs' which include 3 types of antibiotics amongst other things, for when you're doing long sails across the Atlantic or between islands. Available online by prescription at £90. Or if you travel a lot, most countries you can buy them. I've bought them in Spain, Thailand, Vietnam etc.

Thank you to those who have explained the challenges in pharmacies on this thread. I really didn't appreciate the challenges. Thank you for the work you do/did in a frustrating and stressful system.

I'm glad our surgery when we need to visit print out a green slip because then I can try different pharmacies if needed.

I was at the hospital eye clinic this morning and given a green slip . It's simpler for me.

Surrey town, but in villages around. Request repeats on NHS app, confirmed next day, pick up from nominated pharmacy couple of days later. Anything acute, like antibiotics, are requested on the day by the GP, literally sent while you are talking to them, and collected within an hour. I have tipped up early and asked if it is ready, if it isn't they do it there and then.

Op I would like to preface the below essay by saying this is by no means a dig at you or your situation- I completely understand you need your medication. I really appreciate the part of your OP where you said that despite your agony you went in to the pharmacy and you were polite to the workers. I really value that bit, because not many people are. The below essay isn’t directed at you, I’m thinking of the many customers I have every day who aren’t kind to me and who sometimes make me go home and feel like I’m the worst person on earth. So this is for them… and also an insight into the pharmacy world for those who are interested.

I can tell you what’s happening in pharmacies now- Pharmacy first referrals. Since there’s too much pressure on the NHS pharmacies are now able to prescribe medication for 7 minor illnesses. This is all well and good and some pharmacists are very much in favour of this change in order to help take the pressure of the GPs. But we have no more staff than we usually do. We just get constant phone calls from surgeries asking us to take on some of their workload. Constant phone calls from customers who are confused about the services - sorry but I’ve been told about this pharmacy first thing, can you prescribe me ear drops/can you just check if I have tonsillitis/I have been referred here from 111/ I think I have an insect bite/I have a bad cough/could you just do a quick blood pressure check, my doctor has asked me to come here. This is all absolutely fine and we are always happy to help, that is the role we have chosen. But - no more staff!! The phone is ringing off the hook at the same time as I have a long line of customers in the shop. I can’t be in two places at once so the shop floor takes highest priority. We do deliveries as well, we do dossette boxes that we prepare behind the scenes, we get acute prescriptions for antibiotics that go on top of the to do pile… but we dispense roughly 800 items a date in our tiny pharmacy and we only have 1 pharmacist who checks every single item. Next week I am the only dispenser working, meaning while my pharmacist is doing 20 referrals from GP surgeries I have to serve, answer calls, prepare everyone’s prescriptions, prepare dossette boxes, somehow get all the deliveries sent out (and help the delivery driver scan all the items for delivery), cash up the till and bank last weeks earnings, unpack 3 deliveries, order stock (some of at least 8 totes full of medication) and … I am only one minimum wage worker. People give us abuse all day every day and phone up cutting the queue because everyone is in urgent need of their medication, some claiming they will commit suicide, some threatening me personally.
Very often people misunderstand how the pharmacy world works (understandable) but please believe me when I say … we are massively understaffed, we are doing the very best we can. The NHS is struggling, but we also work for the NHS. We aren’t being paid more, we are just constantly given more jobs to do. Oh and last week I found out the hospitals are going to send some prescriptions that are ready to collect to our pharmacy to “take some work load off the hospitals and get more people through your door”. We have no space to store anymore things.

People are so angry because they are unwell and they are forced to wait for their medications but please remember to be respectful to the staff members - there are SO many things going on behind the scenes that people don’t appreciate or are aware of. I understand people don’t understand- I thought I applied for an “easy” job where I’d dispense medication and hand out some white paper bags. I literally had NO idea.
As for all the abuse we get for things not being ready- I am sick to death of how long the surgeries are taking to approve scripts. I get it, you need your medication. But I am constantly having to go out and tell people I’m afraid the surgery hasn’t approved your medication yet. And people tear into me like you wouldn’t believe. And I have to remain professional when all I want to do is go home and cry. I am not allowed to hand out medication without a script. Please please don’t direct your anger at the poor people who are trying to get you your medication.
We need more staff and more money, like everywhere else. But beyond that, we need people to be kind to us. We don’t enjoy doing the surgeries dirty work- we want to give you what you need because we care. We are just overworked and underpaid.

Why is there only one pharmacist though? Shortage of people willing to fill the job, or shop owner unwilling to pay an extra salary? Surely a pharmacy is like any other shop-it gets busier, you employ more people? What am I missing?

I know that regular medication can take a couple of days. Our pharmacy say to request it 2 days before you need it, however I recently had penicillin and as it was acute they did it there and then. I did phone and check they had the script first. Have you tried phoning them first? (NRFT so sorry if you’ve already answered this).

My friends daughter post university lasted less than a year as a locum pharmacist, she hated it. After a break she got a job at the hospital which was better but still didn't like it. Unfortunately she met, married and got pregnant, so now she's stuck there because her salary is needed.

Only one pharmacist at our work place because it is so small and we truly couldn’t fit more people if we tried. Oh and of course it all boils down to money - pharmacists cost more money. They can have 3-4 dispensers all slaving away on minimum wage for little or no gratitude, but no way would they want to pay for more pharmacists in the house. We currently have an experienced pre Reg during her last work experience before her final exams to become a pharmacist - she is worth her weight in gold! She is doing all the referrals so the pharmacist can focus on checking the items and speaking to customers who won’t talk to anyone but the pharmacist.
Next week unfortunately all staff members are off but me - so it’s going to be an interesting week. I have a locum (loan pharmacist) who has never been to our branch before. I’m a trainee dispenser as well and I have to somehow teach her/him our way of doing things. It’s going to be manic and we will have so many complaints. I guess this is what I signed up for though so I will just try not to cry.

I'm in Wales the Welsh government and our health trust board keep banging on.

DON'T bother the hospital
DON'T bother the GP
DO. bother the pharmacist.

Our pharmacy is small cover 12k practice patients, BOOTS chemist closed a few months ago so they've inherited their clients.
They cover a lot of residential and nursing homes so have a van and a delivery driver.

The premises are tiny, the office broom closet size with a desk and a chair. All the nice things they used to sell removed to create more storage space.

Phone ringing off the hook. One pharmacist who's now expected to take customers into the broom closet to look down their throat, ears etc and prescribe to help out the 11 GPs elsewhere in the building.

Out of these 11 GP's only 2 work more than two days a week. Whereas my lovely pharmacist looks exhausted, grey skinned these days.

They can't afford the levels of staff to dispense the prescriptions any quicker. It's not a case of choosing to dispense slowly.

All of the big chains have closed pharmacies, either reducing their branches or pulling out of pharmacy completely. Under the current contract and inflated wholesale prices pharmacies are often loosing money on dispensing prescriptions.

You can ask them to release it back in the system then another pharmacy can pick it up But you would have to go there in person to ask if they’re not picking up the phone. Antibiotics should be on an immediate pick up.

Wow I honestly was not aware that this was the situation you have described it so vividly - I totally get it, how stressful!

Walgreens Own Boots. They're in a financial mess they're trying to offload but no-one is buying. It's dreadful to see such a wonderful British company reduced to this by American business practices

My local pharmacies are terrible, I waited an hour for my DD's medication last week, nearly every item I've been prescribed for myself or family, has been out of stock for the last few months, the quest are horrendous, they have just put signs up saying it will take 3 days at least to process prescriptions. My oldest daughter has a catheter, and had a water infection, they had the prescription for a week, had us calling every day, then said they couldn't find, and then it was out of stock. We ended up in urgent care, as the infection got worse and she was admitted for IV antibiotics. It's an absolute disgrace, I complained but was told they're very busy and it's not they're fault🙄, they have put new signs up now saying they will not tolerate abuse, I think because so many people are kicking up a fuss and complaining.