Services using prescribing are new to community pharmacy and so there is little experience of the performance you should expect from these services. An important part of management is agreeing expectations for performance. Expectations need to be realistic and achievable, and based on reasonable assumptions. They need to be based on an individual pharmacy. The most effective way of doing this is to discuss expectations with your IP and identify how you can work together to meet them.

Expectations could be agreed for the performance measures described above. Availability to deliver a service relates to the pharmacist’s ability to manage other priorities. This will need to take account of other services being provided and the pharmacist’s involvement in other roles in the pharmacy (eg clinical or accuracy checking).

Standards for the time taken to complete a service should be identified through benchmarking; how much time do other pharmacists take to provide the same service? You should also consider the pharmacist’s experience. A pharmacist new to prescribing, or new to a particular service, will take longer than a more experienced pharmacist. These can only be averages as well; some patients do take longer than others. 

It would be inappropriate to set targets for the number of prescriptions written as this would put pressure on the IP to write a prescription in inappropriate circumstances. All consultations will not translate into a prescription.

The number of NHS services claimed should always be 100 per cent of the services delivered.

Influencing prescribing decisions

An important question to ask is whether prescribing decisions can or should be influenced by a manager.

The decision whether to prescribe or not is the accountability of the IP and no effort should be made to influence that.

It is reasonable to influence the choice of the product to be prescribed. This is common for NHS services which will restrict the products that can be prescribed to a limited formulary. There should be no reason why, as a business owner, you cannot choose the products that will form part of the service that you are offering. 

By defining a formulary for the services you offer, you will be able to have greater control of the profit from the services. Yet the choice of product should not only be defined by profit. Scope should be provided within a formulary for product choice to meet the needs of the patient. The opportunity to prescribe more efficacious products in favour of less efficacious but more profitable products should not be restricted. However, requiring a prescriber to prescribe a brand rather than a generic product might be important in terms of the service you want to offer.