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?

Can they aye? The Pharmacies can't afford it.

Nope, just a bag of lots of packets of drugs off the shelf.

FGS for the last time no, not a monopoly system. A data federation based one. Many private companies operate this way.

It also shows how little people understand how solvable a lot of these issues are through technology and just accept the terrible system we have.

@YouAndMeAndThem you can't just order it online. My DD14 uses ADHD medication. It's a controlled product.

I order the prescription online but then it's in the lap of the effed up process.

The procurement process for supply can mandate this.

Yeah, right.

You’re in cloud cuckoo land if you think this is even remotely possible.

I just don't know who you think will organise this massive undertaking. When the single systems we are all using are already so different and complex, and occasionally inadequate. I don't think it's as easy as you think it is and does show ignorance and a bit of entitlement that some IT company has to spend potentially millions on a whole system, probably one each for Wales, England, Scotland and NI as they're all different, all because you can't be arsed to find medication yourself. That's the issue. No one wants to take any responsibility for their own healthcare.

You want a system where private businesses are entirely under NHS control and are forced to sign up to the NHS system that requires them to give away their private information whether they want to or not. That is what is known as a monopoly system.

GPs are not the NHS
Pharmacies are not the NHS

The NHS is a client that GPs and pharmacies have contracts with but they are not their only clients and the NHS needs GPs and pharmacies services more than they need the NHS so the NHS would find itself on very shaky ground if it tried to implement a forced sharing of information as part of their client contract.

ADHD medication is a national shortage!! So if there is a million pound system in place you still wouldn't be able to get them

Does your son have little patience for perimenopausal women?

It was very difficult when there were shortages. Many women were left going to and fro between pharmacies and GPs as product after product went out of stock. And the onus was on the patient to sort it.

I wouldn’t excuse rudeness. But it seems poor behaviour for your son to turn against middle-aged women desperate to get their HRT.

a) the data isn’t in the hands of the community pharmacies
b) pharmacists are already deciding to retire/move abroad/move home/work in a wool shop instead

How would data federation work with a system like where @melj1213 works which doesn't have real-time stock information and the till system only reconciles sales to stock levels overnight after the pharmacy closes?

As a gp it’s very frustrating too - gets worse when you are asked for an alternative then that’s also unavailable and sometimes no alternative!

pharmacist should be able to give an appropriate alternative if available.

why aren’t items available this is what should be asked ?

I don't think it's as easy as you think it is and does show ignorance and a bit of entitlement that some IT company has to spend potentially millions on a whole system, probably one each for Wales, England, Scotland and NI as they're all different, all because you can't be arsed to find medication yourself. That's the issue. No one wants to take any responsibility for their own healthcare

So what happens if you are not in a position to look for your own medicine because you are have a disability or are elderly and wouldn't have the first idea how?

@jeaux90 for these drugs (controlled) you have to be mega on the ball. Can you inch your prescription request forward by one day each month to leave a little more breathing space before meds run out?
If not available in your nominated pharmacy are you aware that you don’t need to wait (indefinitely) but can phone around til you find your meds in stock somewhere and have the prescription sent back to the spine?

I do agree the situation is ridiculous. Of course adults with significant adhd can’t reliably get their meds every 4 weeks as it’s a multi step pot luck process.

I think the main thing making this significantly worse for you in ways posters may not be aware of is that you can’t accumulate adhd drugs in hand as a buffer, you can’t order early, you can only receive 28 days at a time, in a good month it will still take 10 days to actually get the meds. So literally it’s 10 days in every 28 stressing and chasing.
Im pretty sure there are very few other conditions where a better plan hasn’t been devised to ensure that patients can get the drugs they need.

I'll challenge you again. It sounds right up your street, solve it, and make yourself enough money that nobody in your family has to ever work again.....

It won't work because of the human factors.

GPs have enough to do without having authorise the script and then go through every permutation in front of the patient of pharmacy A with generic substitute B, or pharmacy B but not until Tuesday, or pharmacy B and C if you want it today, mixed in with patients saying they can't get to pharmacy B or won't use Pharmacy A etc... It'd be bedlam.

My painkiller was out of stock and apparently hard to get. Had to go back to the surgery and request a generic prescription and the pharmacy delivered (yes delivered without being asked!) my medication 5 days later. Luckily I had enough to tide me over.

Not only that but who is paying for it? If the NHS is going to insist on this system then they need to fund it - GPs and pharmacies have systems that work for them based on their needs and requirements and can currently pick and choose whichever suits them.

The systems used by different companies and entities will all be different even within each industry - who is deciding which is more important and standardising things across the board? For example the store I work in does not make up dosset boxes or blister packs so we don't need the dosset box/blister pack settings options to be a big part of our system; the pharmacy down the road is attached to a residential care home so they spend 90% of their day making up dosset boxes and/or blister packs so the need a system that has those settings as the default and easy to navigate ... But if we both have to provide all of our information to the NHS then we need a system we can both use as well as the GPs who need no dispensing information but do need patient record information but they have to be the same system as our inventory levels need to be visible for GPs when prescribing so they can decide who to send the patient to so they can get their prescription immediately based on current stock availability before any other GP can snaffle it all first ...

If all the pharmacy’s were nhs yeah could be done and would be great

but there independent business it would be like expecting Tesco know if Asda had tomatoes

If asked, the Pharmacy can help out or family can help but this shouldn't be expected for every patient who is perfectly capable of phoning other pharmacies.

I work in the NHS. I am frustrated at the poor IT. I provide secondary care and each of the three acute hospitals I work with has a different electronic patient record system. As it’s in London they are pretty close to each other yet with entirely different systems. Which are of course different to the GP EPR. It’s a nightmare; inefficient and potentially dangerous. I wish we could all use the same system.

I do wonder how a medication database would work though. Tablets are produced by so many different drug companies in this country and abroad. Medications come in so many different formulations. Slow-release, coated, dispersible etc. The same meds might be made by twenty private companies. The manufacturers can be affected by all sorts of things such as lack of product, contamination, local strikes etc. It would require manufacturers to be diligent at updating some kind of private central database continually. There would be no obligation for them to do so so it would be voluntary. Could it work? Possibly. However, it would be absolutely enormous and take coordination internationally.

This is a lot ‘bigger’ than the GP and Boots. However, if if something is out of stock, I think the onus should be on the GP/hospital doctor and local pharmacies to find a solution. But for that to happen there would have to be much more resource given to doctors so they had time to waste on this kind of clinical/admin task. So that is not going to happen.

Missing the point. This is about GPS being able to know when medication is unavailable from the manufacturer, to enable them to give an alternative on the initial prescription.

Ordered prescription.
Went to pharmacy a week or so later.
Told not available.
Did they bother to let me know until I got there?
Did the GP get told?

No.

I had to go to the GP reception and ask for the GP to get an alternative.

This is the 21st century.

Unless your disability and/or age means you can't use a phone to call the local pharmacies and say "I have a prescription for MST prolonged release, 20mg do you have any in stock?" Then everyone is in a position to look for your own medicine.

It's no different to the time before electronic prescriptions when you could only get a paper prescription from the GP and then had to visit every pharmacy in person and if they didn't have it in stock they would say so and perhaps recommend which pharmacy to try next.

We often get people at our pharmacy counter asking for things like wound dressings, if we don't stock them or we are out of stock and can't get them for a few days but the person needs them immediately then I will always give a list of the other pharmacies nearby that are open but tell them to try ABC pharmacy first because they are the district nurses hub so they often have a larger range of dressings than other places.

Pharmacies will usually try to signpost you to the best option of they can't help but there is no way we can ring round or personally sort out every single person who comes for an item they have run out of and we are out of stock of or we would never get anything else done.

You are being so so unreasonable. A prescription is simply a recommendation for a medication. The GP has nothing to do with the pharmacy stock. There are national stock shortages of ADHD medications currently and HRT has had the same issue for ages (and yes at one point it was antibiotics). This is the real problem and where you should be directing your ire. Pressure the government to sort that out. And it’s 100 percent happening because of Brexit (not helped by a sudden unanticipated upsurge in demand for these products). Drug manufacturers often prefer to sell their products to other countries these days as a result of Brexit so we end up with shortages. I’ve spoken with pharmacies about why it’s happening (because as a GP it’s equally frustrating for us when patients are struggling to get their prescriptions filled and calling us about it). This pretty much never happened pre-Brexit.