Any number of harebrained ideas have made things worse for pharmacists. Independent proprietor Sid Dajani picks one apart

I was asked to be a spokesman for a product due to be launched in September. I saw evidence for its efficacy on a day when I was also filmed, gave quotes, provided voice-overs for the advert, and shared my experience of managing infestations. I did not share, however, an experience where a woman once asked to speak to me in private.

I assured her we could have privacy in the dispensary, as the consultation room would be busy for another 10 minutes or so. She said it was OK because she wanted me to check and advise her about lice, as she had nobody to ask. I thought a quick check, some advice about combs and next steps would be all that was required. It had been a particularly busy day and perhaps I should have been more perceptive.

I watched in stunned silence as she unbuckled her belt and dropped her jeans around her ankles in a matter of seconds. At that point my dispenser looked round from the dispensing bench and joined me in a jaw-dropping moment before the lady asked me if I wanted her knickers off or just pulled to one side. The penny dropped, and I realised that she wasn’t referring to the type of lice you find on heads!

The next few moments were blurred; I think I stuttered with utmost composure for the dispenser to take over, then ran out before going back in and apologising for my confused state. She was forgiving and laughed it off, but I was walking around like a zombie for the rest of the day. Next week the GPhC will ask us for an SOP on this!

Crazy debate

I recently attended a meeting and took part in a heated debate – off- and then on-line. To put it politely, it was quixotic, but to put it another way, it was crazy. Whatever school of management you might have studied at, if you have a calculator and an ounce of common sense you can see what a totally and utterly stupid, wasteful, half-baked, impractical, unworkable, and just plain bloody daft idea it is to increase the number of clinical pharmacists in GP surgeries.

This was in response to the question of how to ‘mop-up’ excess pharmacists coming onto the register. While we all agree that workforce planning has been a complete mess for many years – frankly because there’s been no link between professional roles, funding and academic institutions – pharmacists in GP surgeries is not the solution. Funding a second pharmacist in community pharmacies to take on more clinical roles and medicines optimisation, however, makes sense.

What we don't want is GPs commission-ing their own in-house pharmacists, thus diverting resources away from services that could be delivered from pharmacies

By pushing the former we could be risking the expansion of self-care, screening and access, and diverting funding away from what keeps people out of surgeries. What we don't want is GPs commissioning their own in-house pharmacists, thus diverting resources away from services that could be delivered from community pharmacies. That would undermine much of what we are trying to achieve, including pharmacist prescribing.

We need to develop, distribute and roll out clinical roles in community pharmacies. That's the point of HLPs, the new premises regulations, keeping patients out of surgeries, updating consultation rooms to infection control levels, and so on. What we want are more pharmacists in the community and for second pharmacists to take on the wider clinical roles, prescribing and medicines optimisation that cannot be delegated to pharmacy staff.

I’d like to avoid more people going to GP surgeries instead of pharmacies. It would be too enticing for some GPs, in the same way as dispensing, and not always in patients’ best interests if more money were diverted to GP surgeries instead of community pharmacies.

Our patients wouldn't access those services at weekends and evenings, and commissioners would be persuaded to fund them because they’d be heavily influenced by their GP colleagues. We would miss out on national contracts and get more inconsistency – in contrast to the greater consistency and a rolling out of best practice in community pharmacies called for in the ‘Now or Never’ report.

I'm not talking as a contractor here, but as a healthcare professional whose services have been under-funded for many years and whose patients have been denied access to quicker, cost-effective services, despite evidence to show their value. To switch tack to GP surgeries is a retrograde step – and adds to the conflicts of interest around commissioning that already exist.

There is another way to describe this stupid solution and it’s a German word – schlimmbesserung. It is a rare, but useful, term used to describe an effort to make something better that actually makes things worse.

Discovered in Cyprus

I was recently in Cyprus, Paphos to be precise, where I was invited to speak and be part of a couple of Q&A panels at a pharmacy conference. After packing on the last night I wandered into the local town and managed to find a bar with a television set. I had settled down to enjoy a pint and watch a big cup match when a total stranger came up to me and asked if I was a pharmacist from England called Sid Dajani. My mind was doing mental jumping jacks – he might have been a Boots employee or an ex-PCT pharmacist out to ruin my rare night of relaxation.

So I did what you’d all do and denied it, asking him if I looked intelligent enough to be a pharmacist. He apologised, said I should look me up on Google, and laughed as he walked off. Clearly I don’t look intelligent enough to be a pharmacist after all. Hopefully I’ll look more intelligent at the national launch of product X in September!