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Insight: At breaking point

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Insight: At breaking point

By Alexander Humphries*

The last month or so has been one of the toughest times I have ever known in pharmacy. My team is at breaking point and a wave of staff sickness has left our service hanging by a thread...

Quality payments in particular were a major source of stress and a real distraction at a time when we were already overstretched with the rollout of the Falsified Medicines Directive. So much for the scheme driving up standards in pharmacy.

We can argue about whether the QPS is working, but I’m really annoyed that anyone thought that moving the gateway criteria for the second review point of the year was a good idea. Had this change happened for the first review point, pharmacies that didn’t meet the criteria could effectively get a second chance to achieve the standard when review point 2 came around. However, with this mess, any pharmacies that don’t meet the criteria stand to lose quite a lot of money, even if they are meeting all of the other standards.

Within our company we gave up on QP for some of the pharmacies because there simply wasn’t time to meet some of the new gateway criteria. This was really frustrating but if we hadn’t taken that decision, we wouldn’t have met the criteria for any of the pharmacies, such was the workload requirement.

As it was, it took me a lot of time I didn’t have to get my pharmacy QP2.0 ready – and the only way to create that time was for me to come in early and stay late, which hasn’t helped my personal stress levels.

Little sense

The new gateway criteria make little sense anyway – in particular the pointless waste of time that is the Community Pharmacy Patient Questionnaire. We’ve been running this meaningless survey for nearly 15 years now and it is overly complicated, unnecessarily long and gives no useful information at the end of it. So why has it seemingly been elevated in status?

An overhaul and a major edit to no more than five questions (and I don’t mean five questions each with six sub-questions) is a ‘must’ if this is to form a basis of the QPS in the future.

The rest of the NHS, such as A&E, the ambulance service, community services, dentists, GPs, inpatients, maternity care, mental health and outpatient services, can get away with asking: “Would you recommend this X to your friends and family?” So why do we have to plough through two sides of A4 with 32 responses required?

I had three people off from a team of six

FMD waste of time

Then there is the colossal waste of time and money that is the Falsified Medicines Directive. After all the build-up, this has been a total anticlimax.

It just does not work. There is nowhere near enough FMD compliant product in the supply chain, so there is little point in scanning anything until we reach a critical mass of product that is compliant. Personally I’m not going to stress until NHS England opens its chequebook.

The other thing that is keeping me awake at nights is the issue of staff. In a small team there isn’t always a lot of back-up when things go wrong.

One of my technicians has unfortunately been off since before Christmas having been diagnosed with and treated for cancer. Another is on maternity leave. This was challenging when our other dispenser was off for three weeks in January.   

Fortunately we’d taken the decision to try and recruit some maternity cover, which has worked out brilliantly, but I’m really worried that we’re putting too much pressure on the two current technicians, as they’re both working extra hours to help see us through until hopefully one of the others comes back. At one point I had three people off sick from a team of six.

Every time my phone rings early morning I have a panic attack. Who is it now? What’s wrong with them? When will they be back? The only way I can make sure my patients get what they need is to work longer and harder, which puts me under even more pressure.

So when the local CCG wrote to tell me about a dispensing error, I wasn’t surprised. The bottom line was that the alendronic acid in one patient’s MDS had been put in the Tuesday slot, not the Monday.

Yes, technically, this is an error, but the process means I’ve had to write an error report, hold a whole team meeting and report to the NHS database, which I couldn’t do because the ‘computer said no’. Well, I might start saying ‘no’ pretty soon to some of the NHS’s more unreasonable demands. The pressure is becoming intolerable. Who the hell would be a pharmacist these days?

* Pen name of a practising community pharmacist. Alexander Humphries’ views are not necessarily those of Pharmacy Magazine. What is keeping you awake at night? How are your stress levels? Email

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