Why not return switches or allow amendments to specials when the mechanism exists for returning scans of FP10s

Sid Dajani’s shares tales of his injured toe, frustrations with the PPD, and an encounter with a prescriptions fraudster

Well, we’ve finally moved into new Royal Pharmaceutical Society premises and all’s well. I’ve chaired the group that managed buying and branding our members’ new building and it has been four long years. But I hope staff, members and visitors alike will approve. We took on an adventurous, bold, ambitious design which married art into the science of pharmacy and which reflected the spirit and ethos of our proud profession.

Coming home after our first meeting there felt like I’d been given the England football shirt and being asked to play in a re-run of the 1966 World Cup final. That illusion was suddenly shattered when my resident woolly, long-haired, pygmy Mediterranean house donkey stepped on my little toe. The pain was worse than what one may describe as walking on your eyeballs.

Despite immediate first aid, I needed regular painkillers and hobbled around for a few days. I even attended a wedding a few days later, but it was a big mistake to dance.

Painkillers working faster than a Lewis Hamilton lap, I was there on the dance floor; unfortunately my disability made me so uncoordinated that I looked like I was dancing with both legs down one hole of my underpants! I paid a high price in reputation, looks of bemusement and an even more sore foot afterwards – next time I’ll follow the advice I’d normally give others.

Enhanced payment reduced

I found I was £250 short on an enhanced service payment from my local CCG. The weird thing was that I claimed for £260.19 and somehow got the £10.19, so how and where was £250 cleaved off and lost? It was the same invoice, the same total and somehow someone somewhere managed to data input a BACS transfer of £10.19.

I thought claiming electronically was meant to improve efficiency, speed things up, allow for faster payments, reduce errors, be easy to use and provide a better audit trail. We were promised that this ‘new’ system of data input would be a good thing, as reassuring as hot milk at bed-time and as friendly as your granny’s cat. But like the paperboy on a Sunday, you clearly can't rely on it.

I called up, they agreed I was £250 short but they didn’t know how or why. So much for the better audit trail that would see where an error occurred, fix it and stop it happening again. I may have gotten rid of the abacus, the paper and pen, but thank god for my good old-fashioned, cast iron, anti-corrosive, pressure-tested, oven-baked, nuclear bombproof Excel spreadsheets, which I’ll be using for a long time yet.

These came to my aid again. After my usual monthly recheck I was £388.10 out of pocket on a special. I did my usual form filling and the PPD said that all was well and I had been paid what I was owed. I made a phonecall and sent proof of what that payment should have been for. They agreed after another recheck and I got paid. So I needed a recheck-recheck to get my monies worth – I’m still out of pocket for all the work needed to know what I’m getting paid and then all the work chasing it all up.

Falling foul of the rules

I fell foul of the rules when they wouldn’t let me change an SP to an XP and so lost nearly £40 – I was livid. They can return scripts for clarification, but not those switched from exempt to paid, or accidental SP and XP mix-ups. Yet they make mistakes and we are always out of pocket! Why is the PSNC not fighting our corner on this, and is the PPD that reliant on our mistakes that it builds a business plan around them?

Surely it should be about what’s fair and what’s right, not what suits the big beasts of NHS England and the Department of Health. The unwelcome truth is probably that, if we all got paid what we were owed, there wouldn’t be enough in the global sum and the PPD makes endorsing complicated to make money. Why not return switches or allow amendments to specials when the mechanism exists for returning scans of FP10s? Why remove the XP and SP payments claimed from the end of month submissions?

We all know what’s going on but our muted response is not so much one of despair; it's worse than that, it’s resignation. And that’s sad, because we have a proud heritage, a very rich history, a great profession and our service is consistent. Everyone involved, from the front staff to the pharmacist, is perfect. Every time.

The concept of providing a bad service is anathema to most people in the healthcare business. We set our standards high because if our service falls short of expectations we all know about the wonderful Mesperyian delights that await us. Yet we are constantly let down by commissioners and the PPD because we are easy targets and we let them get away with it. As for PSNC, it’s the usual: they came, they saw, they wrote and nothing happened. We are still being ripped off, and badly.

The unfunny comedian

So being wound up like a turning top was a good thing for when the next wannabe comedian came in who happened to have a prescription for 180 dihydrocodeine 30mg tablets. This naturally brought out the detective in me, so I rang the nurse and it turned out that she had only prescribed 18.

I asked him in the privacy of my consultation room how a zero was added to the 18 and there was no answer, just a shrugging smile. By the time I had finished with him it was like he was suddenly injected with leprosy. His hands withered downwards, his smile evaporated, his head bowed, his shoulders stooped and he almost ran out of the consultation room. I’m praying I’ll run into a PPD manager next!