NHS / Pharmacy remodel?

[HufflepuffRavenclaw]

Frustrating experience with pharmacy this morning. DH has woken up with a rash down one side of his torso which I suspect is shingles. NHS website says no need to seek medical attention if no underlying condition, speak to pharmacist for advice on medication. Fine. DH drives to nearest pharmacy open on a Sunday. Pharmacist says there is nothing he can give, and that DH shouldn't even take piriton or use calamine cream without speaking to his GP first, and that DH absolutely MUST phone the GP first thing tomorrow morning. Which is absolutely not what the main NHS website says. 🙄

It is sensible that pharmacies deal with things which do not require a doctor's attention. We have minor ailments in Scotland whereby pharmacists can prescribe things like antibiotics for a UTI and give medication for common conditions for children and those over 60.

I lived in Spain for a few years and their pharmacy system is so much better. For a start, each town or suburb within a larger city has a rota system in operation so that there is a pharmacy always open 24 hours a day - there is a rota which is published online and in each of the pharmacy shop windows so you know who is on duty that night or weekend. Pharmacists can give medical advice and are well-respected in the community. The pharmacist is always the first port of call in Spain as it costs money to see the GP.

The nearest pharmacy to me which is open on a Sunday is miles away. Too far to walk. There are 15 or 20 pharmacies closer but all open 9-5 Monday-Saturday. And I live in a big city.

Our pharmacists are equally well-qualified and know what they are doing. They SHOULD be advising and helping and not passing the buck back to the GPs who are snowed under and don't need to be wasting time on things pharmacists could be dealing with. Yes there's a pharmacist shortage too, but give them a bit more responsibility and respect - for too long it's been see the doctor for everything, then pop along to the pharmacist to get the prescription dispensed. This needs to change.

Totally agree that pharmacists should not be wasting time putting stickers on bags. Let them do the complex stuff, leave the rest to other members of staff.

I don’t recognise the pharmacy first thing the pp also from Scotland describes, we don’t have a designated pharmacy and never have had. I get my prescriptions sentd direct from the gp to the chemist but there is no link - any issues it’s up to me to chase and sort. Even if we did have a designated pharmacy it would be a local one, none of which are open evenings or Sundays.

We have a small pharmacy in our village. They are generally running at full tilt, even without anyone asking to consult the pharmacist. They occasionally put out a message to say that due to staffing shortages the pharmacist has been pulled to cover another branch. Meanwhile the online pharmacies are gaining business (not least because queues are so common). If the local pharmacies haven't got the counter trade, they're not going to be there to provide anything else.

If pharmacists are going to do more, then there is going to need to be some money to fund that, as well as the training.

I'm quite happy with them passing the buck on diagnosis; if they're not sure, I'd rather see someone who is.

Some GP surgeries have an on-site pharmacist, I think? Does that work better? It presumably makes it easier to mentor pharmacists doing training to prescribe.

www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/shingles

this is the Scottish nhs website and the advice is clear. Only see your gp if in a vulnerable group.

@orchid220 that is a huge part of the problem - so many pharmacies have been taken over by multiples who's primary focus is not patient care. They constantly enforce unmanageable targets on their employees to maximise profit. Back in the day, pharmacies were paid £70 for doing a Medicines Review - the chains used to make the pharmacists select patients who didn't really need one (just on a couple of items, well managed) for them so they could get income from government. It is appalling

Problem is the current contract is driving independents out of business because the government does not pay them the costs of many medicines, let alone all the additional costs that have arisen since. The only ones staying afloat are those that are offering services like vaccinations, travel clinics etc as they have an additional income source. And most of those are private services as the pharmacists who have the qualification to prescribe are not allowed to do so for NHS due to contracts and funding. Only pharmacists working in GP Practices or hospitals can prescribe NHS prescriptions. @Wishiwasatailor PGDs would be an option again if government funded and facilitated

@lanthanum GPs are so overworked that they don't want the responsibility of training a pharmacist. It takes a lot of time and the universities don't make it easy with the volume of paperwork they demand too. I have known a few to charge the pharmacist (which the pharmacist must pay out of their own pocket).

Whole system is a mess. I left practising as it was not worth it, overworked in every direction and a thankless job

'And most of those are private services as the pharmacists who have the qualification to prescribe are not allowed to do so for NHS due to contracts and funding. Only pharmacists working in GP Practices or hospitals can prescribe NHS prescriptions.'

I would not mind paying for medication if it meant I can get it when I need it. What's the point of having free healthcare in theory while in practice it's not accessible?

Yabu because you don't know how pharmacy works in the country you live in. Speak to any community pharmacist and they will tell you we are snowed under. Pharmacists are leaving the profession in droves and there are real staff shortages in our pharmacy teams to the point where in some pharmacies it is downright dangerous. Would you want to be paid minimum wage ,have to do learning in ypur own time (unpaid) pass tests and have to put up with avuse from joe public? Thought not. That is why pharmacy staff cannot be retained.

Retailers have all suffered during covid and pharmacy has been no exception. The government expect us to do more and more for free, that eats into profits and the big companies expect you to get by on skeleton staffing, throw a sickness in and you are fucked.

Gp staff are useless at knowing the excusion criteria for the different services so will refer patients to us, only for me to have a consultation realise I can't prescribe for that person and have to refer them back. The patient gets passed because they perceive both the receptionist and I have wasted their time. I'm annoyed because the 15 minutes I've wasted on a consultation that can't go any further means the one member of staff I have had to serve customers, answer the phone and dispense. The other customers will also be annoyed as the waiting times will have to be revised.

I could have helped you as I'm qualified to under a pgd as long as your dh didn't meet the exclusion criteria. The issue is that not every pharmacist will be, there isn't a national expectation that we are. If you get such a referral again I would telephone your nearest pharmacy and ask if the pharmacist on duty would actually be able to help. Saves you wasting your time.

The Scottish pharmacy system is different to that in England. The op has already mentioned she is in Scotland.

In Scotland PGDs vary from one area to the next which is also partly why not each pharmacist will be qualified to do each extra service. This is extra training, not part of your degree.