Onlooker considers how the profession is prone to shooting itself in the foot

FOOT SHOTS

Pharmacists seem to have a great propensity for shooting themselves in the foot. An article in the Daily Mail of June 21 is a classic example of this. The article, described as a “compelling journal” by an anonymous pharmacist, begins with an alarming tale of a patient who has been
taking the wrong medicines and could have died if he had carried on. The dispenser of the prescription is likely to lose his job, we are told. Next there is a tale of a patient in another pharmacy getting in error a fentanyl patch, which could have killed him. Then we hear of a patient given paroxetine instead of tamoxifen. What is the message from our foot-shooter: Check your medicines because your pharmacist can’t be trusted. Next come stories about not being able to help a patient with back pain because her prescription was out of date. Then we hear of pressure from management to do unnecessary MURs, and so the negativity goes on. How can this help public perceptions of us?

Even when we get some positive publicity, as with a recent Daily Telegraph (May 30) news report and comment about the pending remuneration cuts in England, a ‘foot shooter’ has been at it again. The report carried the headline “Chemists face closure by the thousand as ministers cut cash” and a leading article, critical of the government’s plans, called pharmacists the “unsung heroes of a National Health Service that is stumbling under the growing demands placed on it by Britain’s growing, ageing population”. Noticing the coverage, Peter Hopley, a pharmacist from the north-east of England, suggested in a letter to the Telegraph (June 6) that the clamp-down on costs provided a rare opportunity to abolish dispensing by doctors. He pointed out that many were located in market towns and suburbs served by pharmacies. This is where the foot shooter stepped in. A retired pharmacist from Puddletown in Dorset said that he agreed with Mr Hopley in principle but went on to suggest that doctor dispensing was still needed in practice (Daily Telegraph, June 8). “A large proportion of prescriptions will be for the elderly, many of whom do not drive...Buses in our area are a rarity.” I could picture Peter Hopley spitting blood.

DAFT DOCS

The editor of the medical newspaper Pulse has written: “If you designed the NHS from scratch I doubt anyone would invent pharmacies”. He was developing a theme from an article by a GP, who had suggested that one of the ways the NHS could save money was by sacking pharmacists. “Pharmacists”, according to this particular luminary, “duplicate what we do, but badly”. This sort of toffee-nosed stuff from our medical friends is distinctly unhelpful and can only get in the way of the kind of inter- professional cooperation that is needed today more than ever.

SLOW OFF THE MARK?

A letter from a GP in Clinical Pharmacist (May, p135) suggests that pharmacists have been slow to develop compared with nurses. Dr Tim Parkin, who is married to a pharmacist, mentions by way of example that nurses have been fast adopters of prescribing. What Dr Parkin does not
say is that nurses have been given the opportunities and been paid for taking them. Pharmacists, on the other hand, have qualified as independent prescribers but get hardly any chance in community pharmacy to exercise these skills in England. The fault lies with professional bodies not promoting practice models around prescribing, and a parsimonious NHS, which would not want to pay for them in any case.

In Scotland, the situation is different with the Prescription for Excellence agenda envisaging all patients having access to prescribing clinical pharmacists.

It’s about time England caught up.