Pharmacy Jobsworth or Normal?

[bangheadhere40]

I would like opinions on this please as I've not had this in a pharmacy before.

I took time out of work today to go and pick up a prescription from the pharmacy for my husband. It was ordered online and had been signed by a doctor, all good.

When I went the lady in the pharmacy said she wasn't going to give it out as it is too early to order it again on repeat. I explained that the doctor had signed it off and she had the signed prescription ( she doesn't know my husbands medical needs). She said no she wasn't going to give me it for him and she is sending it back to the doctor and to try in a few days.

Is this normal? I always thought if the doctor had signed it then it's good to go!

Of course YANBU OP and people are frothing at the mouth about the wrong issue.

Pharmacists are duty bound to query prescriptions they think might be wrong, so far so good, but this pharmacist just cancelled the prescription and dumped you with the problem. Surely there is an internal system for querying prescriptions with the doctor that the pharmacist could have used? I am not in the U.K. but here the pharmacist picks up the phone and calls the doctor directly. The U.K. system sounds more complicated but I imagine it has a process for pharmacist - doctor communication built it.

And people are underestimating what is involved in arranging repeat long term prescriptions. If you need controlled painkillers, inhalers or a million other things you practically live at the pharmacy. You have to factor in bank holidays, your holidays, etc all in advance and always be available, e.g. never I’ll, never tired, never busy, to deal with it all.

And people are underestimating what is involved in arranging repeat long term prescriptions. If you need controlled painkillers, inhalers or a million other things you practically live at the pharmacy. You have to factor in bank holidays, your holidays, etc all in advance and always be available, e.g. never I’ll, never tired, never busy, to deal with it all

most people who use our pharmacy for their controlled drugs ring us up every 2 weeks, 4 days before their repeat is due, and get us to request the repeat from their doctor, we request them, the doctor provides them - in usually 2 working days, we fill them, the customer rings after 3 days, we tell them it is here waiting to be picked up, or if they need to speak to the doctor about it,

they pick up or speak to their doctor about it, or ask us to deliver (a free service to customers that the pharmacist does not get paid for) because they are too unwell to get out to pick it up.

That is over 90% of our regular controlled drug customers, like most pharmacies.

We encourage customers to take ownership of their own medication requirements, where this is not possible due to mental capacity or physical issues there are other systems in place - dosset boxes, delivery etc.

•keep a register of controlled drugs for legal and stock control purposes
From list of pharmacist responsibilities from @dreichsky. OP, you seem to not understand what this means at all and not understand what it means that your husband is on a controlled drug. I’m not sure why you’re acting like a controlled drug is just like paracetamol. Part of getting the medications we all need for pain is making sure all the i’s are dotted and t’s are crossed. These rules are there because people die of these medications. People in the past have picked up these medications slightly early for months so they could stockpile pills to kill themselves. Pharmacists KNOW this.

I’m on drugs from the controlled drugs list for pain. I understand that I need to be careful about how I take them, how I pick them up from the pharmacist, etc, because there is a huge problem with painkillers in almost every country. My pharmacist is hugely grateful that I have a doctor who has explained all this to me: that pharmacists are the ones who are putting their licenses on the line by keeping the registers of controlled drugs. Since I have two serious chronic illnesses and unfortunately have to pick up a medication every 48 hours (I could have it delivered but it’s better for me to walk to the chemist), all the pharmacists have become my friends. And they say that the stream of people trying to pick up their painkillers early for ENDLESS reasons is constant. These aren’t bad people, but bodies build up tolerance, so people take a few extra, and then they’re down at the chemist trying to explain why they MUST have their prescription early. As my pharmacist says, it seems like they have one gentleman who goes on holiday every single month

So no, you weren’t in the right. The pharmacist called the doctor and the doctor gave them special permission to dispense a controlled drug early and as all controlled drug prescriptions are recorded in a special register, it will be recorded that you picked up his medication early. You weren’t “right.” You just got special treatment. I wouldn’t recommend doing it repeatedly.

And people are underestimating what is involved in arranging repeat long term prescriptions. If you need controlled painkillers, inhalers or a million other things you practically live at the pharmacy. You have to factor in bank holidays, your holidays, etc all in advance and always be available, e.g. never I’ll, never tired, never busy, to deal with it all.

Exactly this. And it's all well and good people sneering at the man wanting to pick up his prescription a few days early while someone was already at the pharmacy but they're ignoring how difficult it can be for some people to get out or to have someone else available to run errands for them.

I take lots of different medications, including controlled drugs. I am fortunate that I can request the prescription and the surgery process it and then send it to their onsite pharmacy at the correct dates. The pharmacy is also open until 10.30 pm every day so collection is not a problem.

I've only had an issue when 1 drug changed to become a controlled drug. Prior to that my consultant had allowed me to vary the dose according to what I needed on any given day and the prescription was worded accordingly - basically up to 300mg twice a day. I requested a repeat, all went through on line ok, prescription shown as at pharmacy. Went to collect it to be told that as it's now a CD the precise dosage has to be given so they had rejected the prescription. Ok. That's the law but why didn't anyone think to phone me to ask what dose I take or to tell me that there was a problem?

The patient should be at the centre of this. At the very least communicate to us that there is a problem and what needs to happen. This isn't our job as patients to have to sort out and I'm shocked at the attitudes of some of the pharmacists on here who.appear to have no understanding of what it's like to live with chronic illness or disability and how that impacts on every aspect of our lives. I understand pharmacists are busy and can't spend hours on the phone trying to ring surgeries but you all have counter staff don't you? Why can't one of them ring the surgery and either pass a message to them explaining the issue or ask the GP to ring back?

Tequila, the whole pharmacy team are busy, a counter assistants time is no less valuable than a pharmacist’s. We also do not have an internal line to the doctor, we phone the same line as everyone else, I deal with 7 different surgeries each with a different process for queries. This in combination with recent medicines shortages means a disproportionate amount of time is spent on the phone rather than face to face with patients.

Where we can we sort problems out when they arise but often patients want a more timely resolution than we are able to offer, this causes conflict (and causes people to take to MN to vilify the pharmacist).

This was someone trying to get a controlled drug earlier than they needed to. People do this for various reasons, including inadvertent overdoses, or stockpiling for a planned overdose, or because they are selling the drug

Or because they have transport to get to the drs/chemists a few days before they ran out of their prescription.

Or because they are going to be away when their previous prescription runs out.

Or just because they have remembered and want to get it there and then.

Or because they work and are only in there town at weekends
There are loads of reasons why you might need to collect a prescription a few days early.

Most aren’t anything to do with anything more criminal than it is convenient and you have time that day to collect your prescription where as on the day you are supposed to be collecting it you might be elsewhere or just don’t have the time.

@BitOfFun and everyone else on here who is choosing to ignore all the posts from GP's and pharmacists about why the practice in he way they do; this is nothing to be with being sanctimonious and not understanding or empathising. It is because they are duty bound as professionals to ensure that follow safe practise guidelines. They are ones who will be potentially struck off if they do not do this. And may be held responsible for someone's death.
If you look online you will find examples of people dying because they have been given the wrong drug/ dose at their own or their family's insistence.

@Oliversmumsarmy so planning / discussion is needed. I take a controlled drug. When I went on holiday, I had to let my GP and pharmacy know I would need to collect early, and explain why. It was fine. I wouldn't have expected them to fill a 28 script 2 weeks earlier without me explained why!

There are many reasons why controlled drugs might be ordered early, some sinister some not but the pharmacist is not always to know which (addicts are often skilled at obtaining drugs by deception) therefore a belt and braces approach is the only way given that they we personally liable for it.

Whilst everyone has their own individual circumstances and things to juggle we do have to deal with hundreds of prescriptions daily not just one persons’.

Also ultimately ownership of the medication has to fall with the patient. We ask all of our patients to order 5 days before running out, this gives time to sort out any problems without being too early. We also offer delivery if a patient cannot come to the pharmacy in person. If there is a genuine reason for early ordering we ask patients to tell us at the point of order so that it can be documented.

JenniR29

I'm sure that we could all claim that we are too busy in our jobs but patient care should be the focus of any healthcare business, surely?

By not telling patients that there's a problem with their script, not contacting the Dr to remedy it and insisting that we have to leave it until the last minute to request a repeat then you are exposing patients to running out of their medication while they wait for it to be sorted.

How is that in the patients best interests?

*There are loads of reasons why you might need to collect a prescription a few days early.

Most aren’t anything to do with anything more criminal than it is convenient and you have time that day to collect your prescription where as on the day you are supposed to be collecting it you might be elsewhere or just don’t have the time*

I think you should work in a pharmacy or hospital for a while.

“Most” being for non-criminal reasons is unlikely. All those reasons, and more, are used by drug seekers. And there are a lot of drug seekers who are very, very skilled at spinning “genuine” stories as to why they just need an extra day.

It’s nothing to do with convenience. It is the law and the pharmacist could be facing criminal charges if they believed all these stories without question and dished out controlled drugs without adhering to the rules.

Do you not think it would be way more convenient for the pharmacist to just give you your script a few days early, and not have to start ringing GP’s, dealing with angry/complaining customers? Of course it would.

It isn’t about convenience. It’s about legally supplying controlled drugs.

We ask all of our patients to order 5 days before running out, this gives time to sort out any problems without being too early

How does it? Takes 48 hrs for Dr to issue prescription. Patient then waits another day to come in and collect it only to be told there's a problem. Somehow they then need to get back to the Dr and then wait for new script to be issued, back to pharmacy , dispensed and collected within 2 days. How does that ensure they get medication in time?

justintimberlakesfishwife

Nice idea but doesn’t work in practice

Dp works away a lot.

He needed to collect his insulin a week early.

Dr was told why.

Dr issues prescription.

Original pharmacist knew dps job and would not have a problem dispensing insulin a week early.

Chemist’s got rid of the older sensible pharmacist who was costing too much money and replaced her with a string of just qualified “locums” who were there one day and gone the next.

They threw dps prescription in the bin. Dp had to beg and plead with the drs receptionist to go and get an emergency prescription signed off by a doctor as he was flying off the next day and his insulin would have run out before he was back.

I used to pick up dps prescription from the doctors and tick that he needed another prescription and pop it in the repeat prescription box as it meant it saved me a trip into town. I would come to collect the prescription the next month and do the same till that was stopped.

Then I didn’t have time to come into town twice in a week.

Everything i am sure is designed to make it more awkward for people

Chemist’s got rid of the older sensible pharmacist who was costing too much money and replaced her with a string of just qualified “locums” who were there one day and gone the next

Is this assumption? If not how do you know? Are you their accountant?

Locums cost a fucking fortune btw, just qualified or not. I can’t imagine it’s in any way cost effective to replace a salaried member of staff with full time hourly-paid Locum cover.

I'm very thankful that a pharmacist checked my prescription when in hospital as the doctor had given the wrong dose on the prescription. It did mean there was a delay in getting my medication but far better that than getting the wrong dose.

Pharmacists are another layer of protection to ensure medications are correct.

@justintimberlakesfishwife, I am not ignoring anybody's explanation of the regulations surrounding pharmacists etc: I am specifically referring to the kind of posters on mumsnet who have a kneejerk response to anybody who needs controlled drugs as irresponsible would-be junkies. I find their eagerness to assume we are treating our pain relief like 'sweeties' etc to be unnecessarily smug.

I think if anyone actually came and worked for even one day in a Pharmacy and saw what we were up against they would immediately retract all these comments!

‘How does it? Takes 48 hrs for Dr to issue prescription. Patient then waits another day to come in and collect it only to be told there's a problem. Somehow they then need to get back to the Dr and then wait for new script to be issued, back to pharmacy , dispensed and collected within 2 days. How does that ensure they get medication in time?’

Because if there is a problem with a prescription we have ordered I don’t just sit on my arse, I contact the surgery, 90% of queries are resolved without the patient ever knowing there was a problem. Sometimes the issue is more complex and requires patient input.

LOL no it definitely would not be cost effective to permanently pay locum pharmacists. Anecdotal of course, but my OH used to be an accountant and he said the wealthiest client he had by far, in terms of money coming in, was a locum pharmacist. Have you any idea how much they get paid??

Also, I don’t think anyone on this thread is judging those who need controlled medications, nor assuming that they are addicted or will become addicted. I know I’m certainly not. People are explaining the rationale behind controlled substances and the very valid reasons why pharmacists take regulations seriously.

My daughter needs medication (albeit non-controlled) to stay alive, so I am not talking from a theoretical perspective, either. Pharmaceutical processes have, at times, caused us huge stress and difficulty, but I’m still able to see the overall picture.

Because if there is a problem with a prescription we have ordered I don’t just sit on my arse, I contact the surgery, 90% of queries are resolved without the patient ever knowing there was a problem. Sometimes the issue is more complex and requires patient input.

With respect you've been saying the exact opposite all along - that you are all too busy in the pharmacy to contact the surgery, that you don't have another line to the Dr and that it's not possible for you or your staff to chase the Dr. Now, you deal with 90% of the issues??

Oliversmumsarmy

I think the prevailing attitude amongst hcps is that anyone with a disability or chronic illness should not have a life but instead should sit at home available at anytime to fit in with the hcp at their convenience.

I see it all the time - with hospital appointments that run late or get cancelled and rearranged at the last minute, requests for tests that occur on different days but very close together necessitating multiple long journeys and days off work when it would help the patient enormously to do them all on the same day, phoning the GP and then waiting for a telephone consultation before being allowed to book an appointment even for a long standing illness (fine if it's an acute problem and you are too ill to go to work anyway. Not fine if you have to keep taking time off work just to be able to book a routine GP appointment). The people who organise the NHS and allied services appear to have given no thought at all to how difficult it makes the lives of people living with disability or chronic illness.

Strong painkillers are dangerous. Having too many available have lead to tragedy. Perhaps she was following a protocol.

Strong painkillers are dangerous

Strong pain killers are dangerous if you misuse them.

Other drugs are dangerous if you misuse them including paracetamol, aspirin and iron tablets. I don't need to be treated like a child simply because I'm unfortunate enough to need to take a controlled drug.

‘With respect you've been saying the exact opposite all along -‘

No. Perhaps I was a little unclear though, allow me to clarify:

Repeats ordered are managed by us, we write down everything that gets ordered and check it off when the prescriptions arrive back in a batch. If we encounter any issues (e.g items missing, prescriptions not signed) we write a list and make a single phone call to the surgery on our own time. This work can be managed and done at any point during the day when we get time.

What I do not have time for is ringing the doctor on demand or chasing up issues multiple times because a patient demands it. Often in this situation it is actually quicker for the patient to take the prescription back to the surgery themselves.

Also Tequila, with all due respect your healthcare in this country is free. Healthcare is one of the most stressful and demanding professions to be in. HCPs do it because they care. If I could help every single person who asked I would, but I quite simply can’t and people can be very unreasonably behaved towards me.

There are finite resources and they are being stretched all the time. The system quite simply cannot bend to accommodate an individuals personal circumstance. Just be grateful you don’t have to pay hundreds of pounds to see a doctor or to have your drugs...yet.

Also Tequila, with all due respect your healthcare in this country is free. Healthcare is one of the most stressful and demanding professions to be in. HCPs do it because they care.

With respect, healthcare in this country isn't free. It is free at the point of delivery. Those of us who pay tax pay for the NHS so it isn't free.

Also, with respect, I was a registered nurse for many years so I know how stressful and demanding it is but guess who I put at the very centre of my work? The patient.