To think GPs should be able to check medication availability

[jeaux90]

I'm absolutely fed up of ordering medication to turn up at the pharmacy to be told the manufacturer is out of stock.

If they have access to the system why isn't the GP checking this and prescribing the alternative? Surely machine learning/AI would help here or are the systems not integrated?

I mean in the whole era of technical progression why are we running between Boots and the GP to get things re-prescribed?

For context this has happened with my HRT, my DD14 ADHD medication, antibiotics etc etc over the last three months.

AIBU to expect an integrated supply approach to prescriptions?

In most businesses badly served customers mean loss of business. Good customer service and supply chain information isn't implemented by fluffy CEOs who want everyone to be happy - they know it cuts the cost of operating the business which equates to more customers served for the money.

Where there is no penalty for poor service there is no incentive to improve service other than the odd lone voice wanting to do the right thing whilst the 90% blame the customer for their business and operational shortcomings.

I find it very telling that not one of the considerations you list includes patient experience, well being or time.

It is however typical of the priorities listed whenever I've done work for the NHS (where anything which would cut costs or modernise business practice gets a response of "but we are special" even if you can show them worked examples of the practice in healthcare).

There is no other industry I work with where people actually boast about having zero experience outside their own little institution and cannot countenance even learning from other trusts, let alone other industries.

This!

We know they are private companies but it really isn't rocket science to communicate to the drs who prescribe stuff what is actually available.

The amount of times I've been stood behind a frail oap who has been told they have to just trawl around pharmacies and source their own medication as it's not in stock 🙄. Well get it in stock then or at least tell someone not to prescribe it until it's available.

But as described above, an item could be in stock at 10am when the dr prescribed it. However, another surgery may have a run of chest infection needing a certain antibiotic. They all go this pharmacy, so by time the oap gets to the pharmacy, all the stock has gone.

What's shocking is the fact that nobody from the NHS seems to prioritise the needs of the patient or understand that the patient is entitled to an acceptable.standard of service. Yes surely it's the patient for whom the NHS exists. Or perhaps not.

No, but the GP can see what's actually available generally at the wholesalers, so would know not to prescribe a drug that none of the wholesalers have, which would be a start.

Yep, the NHS creates an artificial market. Wholesalers and chemists know they don't have to compete nor be efficient because the NHS is the ultimate customer.

That's "micro" level. What people are talking about is "macro" level, where there are national shortages of certain drugs where it's absolutely pointless for a GP to raise a prescription for it because no one has it. Micro level drug shortages are completely different, especially since if there isn't a national shortage, the pharmacy will almost certainly be able to order it in for the next day, so no need for Aunt Mable to go trawling around different pharmacies.

Nail on the head. I genuinely think that a lot of the NHS has forgotten their reason for existence, i.e. looking after patients. It's certainly the impression me and OH have got over the past couple of decades through our extensive dealings with various hospitals, GPs, specialists, etc. Patients seem to be no more than a file number these days.

It always reminds me of the Yes Minister episode where the hospital managers and civil servants and congratulating themselves about their new ward meeting all it's targets, and then the Minister appears and sees an empty ward without any patients.

It's ALL about the internal market in the NHS, i.e. which trust is responsible for treatment costs, and far too many doctors etc are involved in budget meetings and tendering processes.

I find it very telling that not one of the considerations you list includes patient experience, well being or time.

Imo, these were considering their well being

1. reducing people’s temptation to take an overdose by only giving them two months supply of drugs instead of far more
2. not leaving people on the wrong medications for months, because no GP or pharmacist has had to review their prescription for 6 months - especially the elderly and those in care homes on polypharmacy
3. saving the NHS £millions being wasted on drugs, that end up being thrown away, which is better being spent on actual patient treatment, care and drugs, given the budget is finite

As for patients, if they want a better service, they need to stop voting Tory. You can’t get a quart out of pint pot!

@Quisquam in a democracy people may vote for whom they wish. As the majority of HCP's work for the State, GP's excluded, their personal politics should remain private. Working for the state means they should respect their employer - the government of the day (and the people). No other profession would get away with publicly and constantly criticising their employer to every stakeholder available. It would result is dismissal.

I work in the public sector. My personal politics are kept private.

@RosesAndHellebores

It is a democracy. People who want low taxes, get what they pay for with poor public services.

But even these are defining patient well being as what works for the NHS. It also assumes that prescriptions are being reviewed with the patient every six months at the moment which is absolutely not always the case.

Stacked up prescriptions don't reduce any temptation if people can draw them down at will as people have described on this thread. Its also another iteration of "patients are stupid, the patient is to blame when things go wrong" whereas any business which has to engage with its customers will tell you that working with them solves more problems than assuming stupidity and dictating their access.

Why can't the NHS acknowledge that for many patients the way prescribing works puts barriers in the way of accessing medicines whilst also creating significant waste. And not to mention the fact that patient time has a value too. The hardest hit will be those on low wages who have to lose work time and incur travel costs to get to a pharmacy not once but for the subsequent trips due to items not being available (having been texted by the pharmacy to say its ready).
Other systems manage to work with patients more successfully and more cost effectively, why can't the NHS?

@C8H10N4O2

Other systems manage to work with patients more successfully and more cost effectively, why can't the NHS?

Exactly. My first two sets of hearing aids were from the local hospital audiology dept - both times meant several appointments in different buildings over 6 months. Neither set of aids actually solved my hearing loss, despite going back for adjustments a few times. Couldn't quite believe how convoluted the whole process was - different people doing the initial consultation, then back later for hearing test, then another consultation, then a referral to someone who could fit and set the aids, then another for final adjustments - all that before having to go back because they weren't set correctly! So many different people, with delays of several weeks between appointments.

The last two pairs were via Specsavers, in and out in one appointment, including consultation, hearing aid, issue of hearing aids, etc. Far more streamlined, much less wasted time for everyone, and they were actually set correctly so I didn't need to keep going back for adjustments.

@quisquam DH and I, and our parents before us, have paid significant amounts in tax, DH and I for the last 40 years. We have not got much in return from the NHS. Even under a labour government, our children couldn't access grommets - we had to pay for something that was essential.

We need a new system of social healthcare, as on the Continent, or there need to be levels of service introduced from basic to gold with bronze and silver in-between and people shoukd be able to decide whether and how much to top up by.

The hardest hit will be those on low wages who have to lose work time and incur travel costs to get to a pharmacy not once but for the subsequent trips due to items not being available (having been texted by the pharmacy to say its ready).

Tell us all how you’d tackle manufacturers’ shortages of HRT, antibiotics, ADHD drugs, statins, etc which have happened recently.

If the pharmacy has texted to say it’s ready, then I presume the pharmacy has received the prescription, dispensed it and it’s sitting on the shelf waiting to be collected (although they do return items to stock if not collected after a certain amount of time).

in my experience, most people rang around rather than traipsing across town.