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AIBU?

to not be at all surprised the NHS is in the state it's in when we have pharmacists doing this...

57 replies

Jux · 09/11/2017 16:13

I have a load of medication on repeat which is managed by my local Chemist's shop. When I picked up my latest repeat, there was one missing, so it was flagged up via the pharmacy/surgery jungle drums and the pharmacist gave me a few to keep me going until the surgery faxed over the signed prescription. Which was delayed because the new gp wanted a further blood test in order to check the dose, so a couple of weeks later I had the blood test done and the missing tablets appeared at the chemist.

I picked them up and saw that I had been given a whole month's worth so while still in the chemist, I tried to give them back so they could take the extra ones out or so they could give me odds and sods to take me through to the next full repeat (only a week or so away).

No way would they take them. Far too much trouble apparently, not worth it. I should take as many as I need until the next month's prescription comes through and bring back what isn't used.

Now I know, and I'm sure most know, that once you've left the chemist clutching those pills, there's not a damn thing they can do with them if you bring them back, except destroy them; presumably safely disposing of them costs money too.

So that's the cost of the unneeded drugs I have in my house now, and the cost of disposing of them safely when I take them back; and I bet that's repeated throughout the country.

Why? They could have taken half the pills out there and then and they'd have been safe to use for the next prescription. What am I missing?

OP posts:
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Itsanicehotel · 09/11/2017 19:58

If you hadn’t left the shop then it seems crazy not to accept the medication you didn’t need back.

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Roomster101 · 09/11/2017 20:02

If you hadn’t left the shop then it seems crazy not to accept the medication you didn’t need back.

Maybe the medication was only worth a few pence and it wasn't worth taking them back as far as the chemist was concerned. The reason doesn't matter as the chemist is the one out of pocket so it is their choice.

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Jux · 09/11/2017 21:06

Isn’t it Boots out of pocket, or do pharmacists work in a complicated self-employed capacity where they pay for the medications they dispense?

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lougle · 09/11/2017 21:28

It's a different system that is used when they give you an emergency supply. They have to fill in a different supply book to account for it and be reimbursed by the NHSBSA accordingly. When they get a prescription from a GP surgery, they must only supply the medication as stated (either by Brand name if stated, or generic formulation of stated), in the form stated (tablets, capsules, liquid, suppository, pessary, lozenge, topical application or injection), in the dose stated and the quantity stated. They are not allowed to deviate in any way.

So you can't give some back, unless you decline an entire prescription item.

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MaisyPops · 09/11/2017 21:35

I was going to say it's a different set up for an emergency.
I was away from home doing a walking weekend and my inhaler ran out. I needed it to participate safely. I went to the pharmacy and asked if they could do anything. He chatted to me for about 5 mins and then took my details and my gp surgery etc before giving me a new inhaler. I paid the prescription charge. On the label of yhe new inhaler it has in capital letters 'EMERGENCY SUPPLY'.

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Roomster101 · 09/11/2017 21:37

Isn’t it Boots out of pocket, or do pharmacists work in a complicated self-employed capacity where they pay for the medications they dispense?

Boots will be out of pocket, but they are a private business so no NHS money has been wasted.

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Caulk · 09/11/2017 21:40

When you go back in a month, just say you want to collect the others and then collect the one you have too much of when you need it? Unless I’ve missed the point somewhere?

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Jux · 10/11/2017 00:07

Not really Caulk. It’s my own fault, I fid it really relly hard keeping o top of my health needs, especially since my carer was removed as they thought dh could provide the care. He just doesn’t Sad, or very sporadically and unreliably despite his promises. Good intentions pave the road to hell. Unfortunately, it’s my hell.

I do at least know that the pharmacist wasn’t being an arse. I will have to think on what I do vis a vis the meds; so that I can manage them without help, I need to get the whole lot at the same time, then I can keep tabs on when to go to get the next lot.

OP posts:
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melj1213 · 10/11/2017 00:51

I'm not exactly sure why you wouldn't just take the medication they gave you, use it until you get your standard prescription and then keep the rest as an emergency supply?

I take various medications and on occasion I have run out of one or other of them (either because my doctor upped my dose and so I went through my prescription faster but didn't update my repeat prescription schedule or because I needed to have a review or because I was going away and didn't have enough to get me through the whole trip). My medications tend to come in boxes of 30/60/90 pills and they can't split them down ... if I need an emergency supply then they will give me a box of 30 whether I need 2 pills or 28.

If I have any left over then I just keep them in my medication box in case of a future emergency. Like, for example, the time I put a half used blister pack on the side to go and answer the phone, one of the cats knocked it off the table into the washing basket and they ended up going through a hot wash. I didn't want to risk using them as I could see a couple of the blister pockets had let water in during the cycle and couldn't be 100% sure they hadn't been contaminated with the washing detergents so I had to discard a week's worth of tablets ... fortunately I had 2 weeks worth of tablets in reserve from an emergency supply I'd got 6 weeks before.

Once they hit their expiration date (usually a good 6/8 months after they've been dispensed), if I haven't needed to use them, I take any unused ones back to the pharmacy when I collect my next prescription and they will happily dispose of them. That way there is minimal waste and I have an emergency supply on hand to prevent the same thing happening a few months later

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yolofish · 10/11/2017 01:20

One thing I find really bizarre is that my DM gets paracetamol ON SCRIP - why?? you can buy a packet for 30p or something. She's on loads of other meds, she's 87 and housebound, so its convenient for her, but that alone, multiplied by however many thousands of people in the same boat must be costing a fortune?

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Flippingecktucker · 10/11/2017 01:54

Well yes, being 87 and housebound means convenience is the most important thing, surely? Can't see what's puzzling about that at all.

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yolofish · 10/11/2017 02:01

flipping I do her shopping for her? so it would be just as easy and way cheaper for me to pick up the supermarket paracetamol than to have it on the NHS scrip. there must presumably be a large number of other elderly people in a similar situation - scrip price £8.40, supermarket price 30p.

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EmmaGrundyForPM · 10/11/2017 02:04

Most GPs where I live won't prescribe OTC painkillers because you can buy them so cheaply. If you're MIL is housebound why don't you or whoever does her shopping for her but her paracetamol?

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Flippingecktucker · 10/11/2017 02:25

Ah I see what you mean. Although of course an 87 year old won't have to pay for their prescriptions. But I suppose the cost is then borne by the NHS, so do they then have to pay the over-inflated price to the manufacturers do you think?

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NamasteNiki · 10/11/2017 03:32

You've got your GP liaising with the pharmacy, arranging blood tests first to check dosage, faxing prescriptions over to the pharmacy, giving you emergency pills. The pharmacy will be out of pocket for having given you extra drugs.

All that care taken for one drug and you think the system is broken.

Bloody brilliant imo. Cant please some people.

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WellThisIsShit · 10/11/2017 03:43

I also take masses of meds. I’m not sure how your repeat prescriptions work though?

It sounds like they do one order of all at one set time? I wish mine worked like that! How do they get the exact amount of doses of each to equal the same set amount of days?

Mine all run out at different times and come in different size packets. So I have to have someone running back and forth nearly every day to order them, check the exact order got to the pharmacist and pick up controlled drug prescriptions in person, then chase up all the usual errors and try and stop the errors impacting on me, and then finally get the right drugs... rinse and repeat!

It’s an everlasting process. There are always mistakes, with changes not implemented, or wrongly implemented, random drugs that don’t seem to go through for no reason, old drugs suddenly ressurected after 18months which would now kill me if I took them with the others etc etc etc.

It’s uttely knackering.

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Venusflytwat · 10/11/2017 03:47

There really is nothing on here that people won’t pile on about these days, is there?

OP I understand your point, and you’re right, there is a massive overspend on drugs and within that there is waste.

The trouble is around the prescribing regulations. Because the pharmacist isn’t the prescribing authority, they can’t alter the prescription themselves. It’s a safeguard I guess, but one that does lead to some waste.

I would keep them as spares and collect your next prescription as usual, especially if you have multiple prescriptions under one repeat and that normally works ok for you.

I’m sorry your health isn’t great.

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Mummyoflittledragon · 10/11/2017 04:17

I wouldn’t ask for the prescription to be changed. The costs are already sunk. It’ll cost a lot to change the prescription for one month and then change it back again. Not to mention confusion. And you may end up short again because this is bound to cause confusion. Quit while you’re ahead.

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Sirzy · 10/11/2017 04:25

I have given up trying to get ds meds so I can just do one pick up. He is on 15 different ones and it was just getting complicated. Now I keep track in the notes and calander section of my phone and each Monday put in a repeat for the drugs that I will be down to 7 days worth of during that week.

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toomuchtooold · 10/11/2017 06:43

OP I would imagine that the pharmacy has its processes for counting out prescriptions and they don't have a way of adding stuff back in once it's been prescribed. There's probably a database where the incoming stock is recorded and the stock level recalculated when some is removed for a prescription. Adding back wrongly prescribed drugs might be either impossible in their software or they've chosen not to allow it in their process to avoid confusion when they are accounting for all drugs that pass through the pharmacy. I'm just guessing, I'm a chemist chemist not a pharmacist, but I used to work in pharmaceutical manufacturing and the closer you get to the patient, the more redundancy and checking and simplification you get built into your processes. The idea is to make it really hard to make a mistake. Idiot proof processes. 99 times out 100 you might be able to use your intelligence and work it out correctly, but it's that 100th time when you're a bit knackered or someone comes and asks you something halfway through. Does that make any sense?

FWIW though I think it's a perfectly valid question. I think one of the really sad things about the NHS is that the combination of not enough money and British people's loyalty and belief that the only alternative to the NHS as it is now is a free for all US style "system" results in this sort of bunker mentality where any sort of suggestion about how to improve it is treated as a whinge or a sign of disloyalty.

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Oldsu · 10/11/2017 07:21

Reading through these posts I am very glad that I have not and will not use a pharmacy to organise my repeat prescriptions I get paper ones, I check them myself and take them into what ever chemist I am near at the time, I have never run out, never been given the wrong medication, unlike DH who uses Boots and has awful problems not being given the medication he is not supposed to stop taking and being given the medication he doesn't actually need that month.

I have checked on the NHS digital prescription site and I will still be able to get tokens to take to the pharmacy of my choice after the final phase of the scheme and that's what I will be doing

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Sirzy · 10/11/2017 07:23

Our local trust has stopped pharmacies being able to order for patients. It now has to be the patient/carer who orders the repeat via the Gp because of the amount of waste and over prescribing it was leading to.

The automatic is still for the prescription to be sent straight to the pharmacy but ds has stamped on his “not for pharmacy” as the pharmacy they send them to won’t supply one of his drugs and I like to check everything before leaving the building to make sure the gp hasn’t made an error

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PurplePillowCase · 10/11/2017 07:39

usually it's the other way round.
only to a pharmacist a month is 28 days...
left us short regularly.

so annoying.

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yowerohotesies · 10/11/2017 07:59

Unless the pills have only a 1 month shelf life and have a "do not consume after 10th December" stamped on them, nothing is being wasted. Nothing is going to be thrown away. You will have a couple of weeks buffer-supply in the house and so long as you keep finishing up the old before you start the new all will be well.

In a year's time you may well find there's another delay and you'll use up the buffer supply instead of needing the pharmacy's emergency assistance.

The NHS is in trouble for lots of reasons but this really isn't one.

People making regular gp appointments for themselves when there is no illness

People demanding antibiotics for viruses

People not taking the full course of antibiotics when they do need it causing antibiotic-resistant infections to thrive

People happily paying prescription charge for expensive drugs but trying to circumvent the prescription charge for cheaper drugs with private prescriptions

People going to a&e when self-care or popping into a pharmacy is all they need.

Underpaying and overworking NHS staff so much they get demotivated and leave, then filling the void with agency staff that they need to pay twice as much for.

Supply and demand for agency staff is what sets the cost and brexit making the UK a less attractive place for qualified staff from overseas is going to reduce supply and push up costs.

Senior policy makers ignoring the time bomb that is an NHS staff population overwhelmingly approaching retirement age with ridiculously low capacity to train up and give experience to new entrants.

I'll give it a rest there - there are plenty more but really op you having some pills in-hand that you aren't going to throw away is not even wasting a penny.

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Esker · 10/11/2017 08:04

This really isn't a big deal. Not sure why you are so exercised, and I certainly don't think it's valid to extrapolate judgements about the NHS in general from this particular occurrence.

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