I reckon it takes up to two hours a day now to locate stock to fulfil prescriptions to ensure patients access the medicines they need in a timely manner – this is beyond a joke. Across the community pharmacy sector, among independent colleagues and multiples too, the funding cuts have driven operational efficiencies in reducing headcount, shorter opening hours and streamlined costs. Now, much needed professional resource is diverted to logistics: locating medicines, which deters investment in innovative services and training for the future.
To say nothing of escalating stock prices, with concessionary prices not necessarily covering the acquisition costs. This is unsustainable in the short-, medium- or long-term. Take your pick. I watched Oliver! on the telly the other day. You’ve got to pick a pocket or two, eh?
What the people responsible for this crazy system need to understand is the frustration felt by patients as well as clinical staff. It’s getting past ‘inconvenient’. Patients take it out on pharmacy staff, fine. But I’m concerned about the absence of any acknowledgement or worry about the impact this could all be having on adherence, or the optimal management of long-term conditions.
I haven’t even got to Brexit yet. You can forget ‘warm words’ from Health Secretary Matt Hancock and his consignment of fridges. I’m concerned that a supply chain crisis will result in pressure on urgent care and vital NHS resources caused by patient admissions directly related to failure to supply.
There’s been a lot of talk in the context of Brexit about ‘just in time’ delivery. We need an overhaul of the reimbursement and remuneration system to ensure real time reimbursement based on accurate pricing of acquired medicines. Mr Hancock’s digital revolution should be able to deliver that, right? As a start, it would be helpful to have some kind of advance notice of supply chain issues, or of prices escalating out of control, to help with planning. Someone has the information, right? Or is the point that they aren’t sharing?
In the meantime, those of us at the coalface are facing these issues on a daily basis. We all understand that the impact of a “no deal Brexit” will evolve over time, but there are some very real problems facing pharmacists and their teams NOW. To provide reassuring noises to patients that it will be alright with their medicines post 29 March, I need to feel reassured that somebody is doing something about the current supply crisis. There, I called it.
Everyone needs to understand the impact of medicines shortages on patients, community pharmacies and the NHS. It costs the NHS when sourcing alternative medicines to outages. Patients may be less safe if they do not recognise their medicines and fail to take them correctly out of fear or frustration. Pharmacy workload goes up as patients need to be counselled about the alternatives, GPs need to be consulted, and stock chased around the system. Anguish for all parties. Conflict if you’re unlucky, for example where formulary drugs are on restricted allocations, or the formulary prevents alternatives even when there is a genuine issue.
Prescribers and medicines management teams seem to have a default position of denial that there are genuine stock issues – but this isn’t fake news.
And while we’re here, let’s take a moment to appreciate the work of those GP pharmacist colleagues who understand our plight. Sadly there are still some that should know better, but oddly have no empathy either for their erstwhile collegues.
They too could benefit from accurate information on stock issues, which can change from hour to hour and pharmacy to pharmacy. They need to be flexible to switches or alternatives being prescribed, and recognise the financial burden being shouldered by pharmacy all too often.
Something needs to change. Fast.