Boots withdrawing dossette box service

[Itsnotallaboutmoney]

www.bbc.co.uk/news/health-61881272.amp

Name changed for this as I really don’t mind it ending up in the Daily Fail for once.

I seriously cannot believe what Boots are planning. For those of us who have elderly parents (particularly with memory issues) who we are trying to persuade to allow help in the home (to no avail) this is a kick in the teeth. Whilst I understand it’s probably time-consuming etc to fill the boxes, the sheer danger of missed tablets, overdosing or the wrong combination as a duty of care from a profession surely outweighs the cost-saving element of providing this service. My in-laws both currently have memory issues and without this service, the lady who comes in to help each day would not have a clue as to what they have taken each day. My own parents at-home care service will not distribute any meds not in a pharmacy-filled dossette box. So where do the elderly and vulnerable go from here?

This morning I couldn’t imagine anything getting me more wound up than having to book a hotel stay in order for my child to get to a public examination today.. but here we are. I sincerely hope Boots have not tried to sneak this in on a day when everyone is watching the rail strike hoping no one has noticed 😡

The slide can be a problem as it depends on the user doing a manual stop

The trick with the blister pack is to get the pharmacist to go through the meds with you. And check that the pills are not substituted for different

The appointment room will have a table.

Pop the single blister.

Lay the meds on the pill list.

take a picture (back and front) that shows the markings and size.

Do that for all the individual times and reseal the pack.

You can also upload the pics to whoever is doing holiday cover and has a question about which meds are which

For those pharmacists explaining why they are struggling to provide the blister pack/dossette service - what do you see as the solution? It just seems wrong to just withdraw a service many of us rely on to take our medication properly or for carers to be able to give/prompt meds? I mean why did pharmacists start providing this service and what happened before that?

They do like to give different brands that look completely different which just throws another spanner into the works. It's all so confusing!

They are no where near as good.

Much harder to see where people have overdosed or forgotten to take medication and require much more active management should someone go in to hospital. They are also much harder to read.

YANBU. It's going to have a massive impact on social care, far more people will need care to administer medication. Any savings made will be wasted in increased care costs.

I don't for a SECOND think boots profits are so precarious they need to do this!

This is on top of the fact they also charge for delivery which they introduced a while back.

When I'm bad I need my meds delivered and I need to use dosette boxes as my memory gets messed up.

With this and their retail prices they are going to go the way of Woolworths if they aren't careful!

Woolies priced themselves out of the market but didn't provide good enough quality of goods or service and thus they went bust, boots are heading the same way - idiots!!

And now I've just read up on their history entry and I think I won't be using them again.

This move could well result in life altering medical incidents or even fatalities

"Just use another pharmacy" so then those pharmacies will end up overwhelmed in having to provide this service as boots and Lloyds refuse

@Appzy the nhs itself can't fund anything without appropriate and sufficient funding from the govt, they are deliberately under funding the nhs so people get frustrated and think private will be better at which point the nhs will likely be sold to American healthcare providers who are predominantly interested in profit and give few fucks about British patients!

I think boots is American owned at this point too

A chart may not work with eg Alzheimer's as they may mark it/not mark it erroneously. With a blister pack a carer can accurately see what has/hasn't been taken

@PurpleButterflyWings you seem to have not read the thread properly or understood the issue

Not every patient is capable of filling their own boxes at home accurately or has someone to do that for them - when I'm bad I'm in that position!

As you age and gradually have more difficulty and health issues perhaps your empathy and understanding will kick in?

6 or 7 people I know use them, each little compartment holds 5 or 6 tablets (which is as much as many other dossette boxes,) and several people I know have arthritis and can easily open the little 'doors.'

Do they have people who can fill the boxes for them if they can't? Can they open the original packaging the meds come in if they have arthritis etc?

PLUS as has been pointed out several times care staff aren't allowed to dispense to patients from diy boxes

PLUS read the comment by the paramedic re taking meds into hospital for patients the diy boxes aren't appropriate

This as I said basically comes down to trying to make the nhs look untenable when actually properly funded and run it's way better than private

I can't speak for other pharmacies but mine would never stop the service for existing blister pack patients. It would be unfair and we know how much the packs make life easier for our most vulnerable patients.
Going forward though, I don't know what will happen, we can't recruit staff anymore (technicians, dispensers, counter assistant etc), as people aren't interested in the job due to the amount of stress and abuse you get for minimum, or just above minimum wage.

Could your CCO, or another member of the CMHT support you to do your own? Only asking as when I was on a CMHT placement I would do this, alongside support workers, assistant practitioners, nursing associates or it could be done quickly and efficiently by our NMP or doctor during reviews.

Those aren't the boxes that were talking about.

The boxes boots (and many, many other pharmacies) are talking about withdrawing are ones where the pharmacist fills the boxes for the patient. Specifically for patients who cannot do them themselves. The boxes are sealed so can't be tampered with until they take out the dose. The boxes hold 35 slots (5 lots of pills, 7 days a week)

The box you linked to has to be filled by someone, a pharmacist can't do it, a care agency won't administer from it.

For the avoidance of doubt, this is what the article is talking about:

I don’t know any pharmacy that has time for that.
I make up boxes Once a week, once they are sealed they can’t be opened and resealed.
And if the tablets are generics then unfortunately you get what you’re given, we cannot guarantee that the brand will be the same every month.
I make up trays for 70 patients a month and they all get 4 each, that’s 280 trays and there is only me that does them.

My grandparents have had their dossette boxes withdrawn by their local pharmacy. Blanket refusal to do them. I've been trying for a month to find a local pharmacy who will do it but haven't had any success. They don't want me to use the internet as at 91 and 89- they both think it's witchcraft/ a scam etc. 🤦🏼‍♀️ My grandad is blind and my grandma has such severe COPD that she's practically bed bound. She's got all of her faculties but administering medication for them both and potting it up exhausts her. I've been doing it for them but it massively worries me in case I get it wrong.

My grandma recently went into hospital with pneumonia and the ambulance crew wouldn't take all of her meds- which meant that for the 10 hours she was stuck on a trolley in a&e she missed her medications. It also meant that they had to re-prescribe them all for her in hospital and they ended up missing a couple of her tablets off which led to her getting a blood clot.

The whole system is a mess now. I don't think there's a part of the NHS that isn't malfunctioning now. My own department seems to lurch from disaster to disaster via staffing crises and budget cuts. The time saved in pharmacies will translate into harm for some patients but I'm not sure what else they can do if they physically don't have the staff to dispense.

I'm going to give the chart a go as I can't get a blister pack but honestly it is something else for me to remember...which some times, I might, sometimes I won't which then makes it useless.

But that still means someone newly needing a blister pack or moving to that area or coming out of hospital will get left without one.

My Care Co has just left...who knows when I'll get another and of course they don't really have time for doing anything like that. You'd have to see them every week too. Plus of course it's all over the phone since Covid. I don't know what you mean by a doctor? A psych isn't going to go round someone's house every week to dish out their meds. Sorry, I've probably misunderstood! Were you a student when you did this? I could do with a keen student to help out! ☺️

I don't really get the "it's time consuming" argument.
Caring for someone who is unable to manage their own care take time, whether that be helping them get dressed, personal care or taking medication.
Dossette boxes are part of caring for someone. As pp's have said, carers won't administer medication unless it's from a dossette box (we were instructed to keep my FIL's in a safe in his home).

We can do this, and where I work we prefer it. We run from a Mar chart because if 1 medication needs removing or changing from a dissent we have to return the whole lot to the pharmacy to be altered, which can take ages.

if we use boxed meds we can change directives in a heartbeat.

If you are working in a care home are you asking the care staff to independently manage individuals medication?
Or is there an obligation on the faculity to have a nurse or other suitable/ qualified person to take responsibility for dispensing meds?

Boots are a private business, not a charity or a family member or a public service, so they don’t actually have any obligation to provide anything to anyone that eats into their profits to do so. Boots aren’t responsible for caring for anyone, no moral obligation exists to provide blister packs for free. Customers choose to go there and expect to get their prescription dispensed but that’s it. It’s a free market, you can take it anywhere, and they can choose what services they offer, Boots is not free at the point of need.

There should be no financial incentives to do blisters on a weekly basis. For stable conditions its more time effective to dispense 4 weekly.

The packaging is a purchasing decision which can be changed.

You may not have the time to do a one off check on what your packaging, but you are then asking the reciepient to take on trust that the correct medication has been included and that the new colour or shape pill is not something which will cause harm.

Everyone is human and makes mistakes.

The package list should have suficient discriptive detail to allow the individual check the individual pills off themselves and referral back to the staff ID the ones which are in doubt.

Changes to the drug should result in the detail for the generic drugs being updated on the list as changes can lead to drug refusal or a belief that there is a missing pill.

IMO this thread demonstrates how the cuts and underfunding in one section of health care leads to avoidable knockon effects. Without blisters some homecare arrangements are not possible forcing people who could be managed in their own environments into higher level care
It would increese hospital admissions due to an inability to properly medicate conditions.

We are ‘supported living’. All staff are meds trained.

mortified for you that you failed to understand what OP (and everyone else) is talking about and went on that pointless rant

The time consuming part limits who you could ask to help you.

@UndertheCedartree

Yup, it was a few years ago now and they had to backtrack as the backlash was as swift and brutal as it was highly entertaining but yes, they claimed they didn’t want to encourage “inappropriate use”: metro.co.uk/2017/07/20/boots-claim-the-morning-after-pill-is-so-expensive-to-discourage-inappropriate-use-6793283/amp/

As I say, cunts. And American private equity owned cunts at that.

Even if the patient has a 4 weekly prescription they still get 4 trays as they are a weeks worth each. It’s a huge task and it takes me a day each week to make up just 30 scrips. Normally 30 patients prescriptions would take me less than an hour.
The Cost isn’t just in the packaging, it’s also my time as a pharmacy tech and the pharmacist who checks my work.

No, what I meant was why it's used as an argument for pharmacists withdrawing the service. Everything we do consumes time, but we don't stop doing something important because it's takes too much time.