Public Health England reports seem to have less impact than a letter to Santa

During a particularly fast-paced month, independent proprietor Sid Dajani finds that it’s not only patients obstructing his professional manoeuvres

The pharmacy world has been calling for change for years. The stars are aligning and are pointing to a clinical and digital future! Over the past few years community pharmacy teams have been increasingly at the forefront of prevention, early detection and treatment of illness, and I dare say we will play a significant role in delivering our shared ambitions for the public’s health. For this to happen, the commissioning of services needs to improve and increase, and the public need to understand what they can access at their pharmacy.

Public Health England reports seem to have less impact than a letter to Santa. The sudden announcement of a national flu vaccination service, however, shows that possibly PHE asked for Santa’s help and inspiration ...

What a very busy October it has been. It’s defied gravity, common sense, the laws of physics and polite society, with 6am starts and finishes as late as 1am. I’ve personally vaccinated over 500 patients across four locations, and that’s on top of my day job. Despite forgetting to submit the flu paperwork with my prescription batch, I came out unscathed.

Thankfully, the flu season does not last all year, or else I would be sponsored by Marlboro and Red Bull, be tempted to wear my underpants on the outside of my trousers and work alongside a constant loop of Rocky sound tracks. All in all, patients are very happy with this and indeed with the general range of services they can access from my and around 11,000 other pharmacies. But some patients still see us a fast food version of medicines and don’t want to wait a few minutes while we help others with their emergencies or concerns.

A poor attitude

Many are appreciative that they can access our expertise without an appointment, and that our opening hours fit in with their working hours, and that we fill health gaps at weekends and on bank holidays, but there are some whose attitude frankly stinks. One accused us of being slow pill counters and, while naïvety can be understandable, ignorance is rarely ever bliss or an excuse for rudeness. So I have no qualms in telling them to go to Boots where they can huff and puff and blow their dispensaries down.

I have therefore decided to insert a question in our mandatory annual patient survey around waiting times: ‘How long do you think waiting times should be? a) 15 minutes b) 10 minutes c) 5 minutes d) 1 minute [we cannot guarantee the correct medicine or dosage instructions].’

Q&A: Silly or otherwise

I don't mind answering questions, no matter how trivial or silly some may think them. The lady about to start taking warfarin being very concerned about excessive bleeding during menstruation, the age-old confusion between anabolic and corticosteroids, being asked if there was a ‘morning-before pill’ version of the morning-after pill. Each question is sincerely answered to ensure patients understand what I’m saying, are aware of the choices available and the realistic outcomes.

But on other occasions I ensure that I don’t say what I’m actually thinking. For example, to those patients who bring in a prescription with at least 10 items during busy periods and tell us to speed up. I want to say: “Go into McDonalds, order six happy meals, tell them you have a taxi waiting, and see if they give a monkey’s!”

There are others who will phone at closing time and say, “My wife's on her way down with a repeat script, can you hold on till she gets there?” When you refuse, they shout about how they really need this medication and they'll end up in hospital without it. To which, of course, the reply has to be: “Then why leave it until you have none left and it's the weekend?”

I also find it equally frustrating when I have several people waiting and I’m on a call and they are constantly yelling at their families. Meanwhile, I’m thinking, “No really, please continue your phone conversation while I continue your consultation”.

The worst offenders

These interchanges happen regularly, but they are far more grating in the busiest months and sometimes other pharmacists are even worse. We had a lady on a mobility scooter wanting medicines that we couldn’t obtain until the next day. We contacted our nearest pharmacy to check availability, and subsequently referred her there as she couldn’t wait. But because she couldn't travel, we asked the pharmacist if our delivery driver could borrow the items, explaining why the lady couldn't make her own way up there.

He refused without explanation, other than to say that he was the pharmacist and his answer was final. What tommyrot! Fortunately for him, he was a locum and because I didn’t get his name or when he’d be in next, I couldn’t go and use my equivalent expertise to eviscerate his logic and tell him what a qualified burk he was.

I hope this pharmacist's blood-curding lack of care and patient support is rare, because otherwise it jeopardises our position at the helm of NHS provider performance, efficiency and productivity. Perhaps I can offer another question inspired by this fiasco: “If you call a tail, a leg, how many legs does a house donkey have?” a) Four b) Five.

The reality is that it doesn't matter what you call it, a tail will never be a leg. Likewise, while a person may be a registered pharmacist, it clearly doesn't mean they’re a caring, patient-centric healthcare professional. I’m sure this pharmacist is good to his mum, buys a copy of the Big Issue and reads the PJ, but when it comes to patient care, he’s about as useful as a knitted condom!

Photo credit: Nic Redhead