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 😡

That makes sense. So they're pushing it back onto patients and their carers. And in the situation where carers insist meds are in dossette boxes, it will need to be GP services that do it?

I get what you're saying but don't pharmacists have a duty of care as health care professionals?

@UndertheCedartree the duty of care doesn't extend to additional services, no.

The solution is that it needs to be funded by the nhs, a dossette box easily takes 3 or four times longer to prepare than a standard prescription so more staff are needed, the boxes and materials required are more expensive than standard bottles and boxes and more space is required to store the prescriptions.

Pharmacies have been absorbing the extra cost for years as a goodwill gesture and to help patients, however due to rising costs and the goverment trying to cut payments to pharmacies it's getting to the point where many just can't afford to provide the service any more. It's shit because it is almost certainly going to adversely affect some patients and i believe will ultimately cost lives and money(due to people ending up in hospital when not taking meds properly or going into care earlier due to being unable to manage their medication)

Basically it's easy for the goverment to try to save money by reducing what they pay to pharmacies but it's patients who are going to suffer when services like this are withdrawn

The solution is that it needs to be funded by the nhs

We're doomed then. Or just the vulnerable are.

It's not just money it's the staff time it takes to do each script, each prescription takes 3-4 times longer to prepare and check. Many pharmacies are short staffed and having trouble recruiting more so are limited physically in the number of boxes they can safely dispense

Even in hospitals doctors are not allowed /trained to handle regular dispensing of meds. So the GP services would have to get funding from a dedicated nurse or pharmacist. It would be more logical and economical to cost that into health care at the point of origin.

I hear you op. This is just one more hurdle to jump over when you're trying to care for vulnerable people. Yes you can buy and fill your own boxes, yes you could shop around and find another pharmacy, yes you could pay for the service.

But when you're trying so hard to keep everything going, removing (or making it harder to access) this service is just one extra problem you really don't need.

And older people who don't have anyone to look around for them or fight their corner are really going to struggle.

I understand why pharmacies can't keep doing it for free but it's just one more small thing chipping away at the balancing act that is caring for vulnerable people.

I have to take regular medication but it's only 4 tablets a day - 2 each morning and evening. Last night I accidentally took 200mg instead of the regular 150mg - very easy mistake as pharmacist changed brands (AGAIN) on my new prescription so the two pills are quite similar in appearance. This morning I have a headache and feel slightly sick but that's thankfully as far as it goes because it was a minor mistake - but if I'd not noticed I could have ended up in hospital - I know this because it's what happened last time brands were changed and I replicated the error for 5 days in a row

I've just seen this thread. If I can make a mistake with such a simple dosage more than once then people on multiple medications could face serious problems and the results could be a lot worse than a headache. Brand changes are a nightmare but add in memory problems it becomes extremely serious.

YANBU OP.

It’s a difficult one. I fully understand the pressure pharmacies are under. Equally, I know quite a number of vulnerable people will be at risk if they don’t receive blister packs/dosette boxes. I do think there are some people who could do their own or pay. The trouble is, it’s impossible to work out those who can and those who can’t. I worry the most vulnerable will suffer.

Boots have been declining on many ways in recent years. They are a business but they do get funding for offering prescription services, it doesn't extend to dosset boxes which do take longer but as their business crumbles due to greedy bosses and treating staff like crap hopefully a solution can be found. They are invaluable to many people.

So what's the solution? Because presumably this essential part of prescribing medication isn't done by the NHS as pharmacists carried it out. Now, they are finding they can't cope doing it and people are just falling through the cracks as they have noone else to turn to because pharmacists were providing this service and now aren't.

As an aside my first job was in a pharmacy and as well as being safer as multiple medications at different times of day can be hard to remember- lots of the packets and bottles can be really challenging for someone with limited mobility to open :( I feel unfair to blame boots specifically but hopefully the gov does something to support pharmacies (not boots though as its shite).

That's what I thought.

The solution will probably become someone enterprising setting up a new company who do this and post them out.

A machine could absolutely be created to undertake this function but would be costly to develop and set up.

A new company of pharmacists and technicians who do this work remotely in a warehouse type location would be less expensive than staffing a high street pharmacy where multiple tasks conflict.

Unfortunately it would also be a service they would no doubt charge a fee for.

Like anything else it cost and no one prepared to pay

@UndertheCedartree If you can physically do it but it is your memory and mental health that prevents you currently, as your posts suggest, making your own chart and setting reminder alerts/alarms (for taking medication and for making up dosette boxes) on your phone would help. It doesn’t solve the issue of outside carers but it could work for you as that isn’t relevant.

You don’t really need to get your head around multiple medications. You just follow the directions on the labels on the tablet boxes and put the tablets in the boxes for the right time even if you can’t remember week to week. So, once a week you get all the medication boxes out, on the box of medication A it says take one once a day so you put one in each day’s morning box then put that box back in the drawer/cupboard (or bin/recycling if empty), and on the box of medication B it says take 1 four times a day so you put 1 in each box then put that box away, and on the box of medication C it says take 2 twice a day so you put two in the morning and night boxes and so on until you have done all the medications. You could even have a chart where you tick off each medication as you go. If any of the boxes say “take as directed” ask the GP to alter the prescription.

I do 3 DS’s (all 3 take more than 20 tablets a day) and mine (only a few) every week. Yes, it takes time but so does every other aspect of their care.

I have RA and struggle to open my numerous medication packs but was refused dossette a long time ago sadly. I have nobody to do it and it's painful and lengthy process to do myself

@Neu That's awful, I'm so sorry.

So what's the solution? Because presumably this essential part of prescribing medication isn't done by the NHS as pharmacists carried it out.

Generally, pharmacists don’t do it - dispensers do it. If they are snowed under, and the pharmacist has nothing to do, they might help out; but some won’t!

Dispensers get paid around or maybe 20p above NMW. They find dossette boxes boring and stressful. They also have other work to do, like making up prescriptions for people, who walk in; unpacking the new supplies every day; chasing up GP practices ; studying; learning off the pharmacist how to progress in their skills…..There is a limit to how many dossette boxes they can do in a week, balancing it with all their other work.

Dispenser quit over too many dossette boxes to do, at a local pharmacy. DD was offered the job, having previously worked there - she turned it down, as she didn’t want to do so many either!

People can work on the tills in a supermarket for the same wages and no responsibility or studying to do! Pharmacy staff need to be paid more! Also there is too much abuse from the public!

There are aids you can get to help if you struggle with the physical ability to pop out tablets from the packets. There are electronic mediation dispensers that you can program. There are pharmacies that offer the service for a charge. There are various options to be explored. I appreciate this won’t work for everyone.

The service for dosette boxes should remain for those who are the most vulnerable such as; those who are severely cognitively impaired and those who have care staff who cannot administer mediation out of the packets. Perhaps Boots needed to make their criteria more stringent before stopping completely.

If you limit to those with a cognitive impairment or a carer who comes in, you’re screwing over all the people who have a disability that limts the use of their hands. My husband has zero chance of opening a tablet bottle, the usual plasic tray they come in or using a medical box you buy in the shops. Without a dossette box he can’t access his medication, and no, he can’t use the tablet ‘rolls’ or anything with buttons or switches.

Yes they’re really good. If you go out for the day, you just tear off the right pouches and they take up no space.

I can see the headline:
Elderly patient dies after Pharmacy mixes up drug!!!!!!!!!!

Probably the people putting them into the daily containers are not trained pharmacists and there is a risk of error - and being sued.

That is exactly what the pouching pharmacies already do. Warehouses. Automated. Pharmacist checked. Posted. Free service. Honestly I feel quite evangelical about it.