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Insight: Open all hours

Insight: Open all hours

by Alexander Humphries*

Am I alone in thinking that opening on Saturdays is becoming more hassle than it's worth?

There was a time when the public seemed to be grateful that they got any service at the weekend. The GP and the dentist were closed, so having a recognisable healthcare professional available seemed to be valued. Over the past few months, however, it seems that, whatever I do, the public just wants more. Is it simply that I am getting grumpy in my old age, or are public expectations becoming unrealistically high?

Before I get bombarded with the leftover fruit and veg from my colleagues in supermarket pharmacies, I understand perfectly that we are in a service industry and need to be available when and where our customers want us €“ but surely there are limits.

Challenging

There are many challenges to weekend working. For starters, nobody wants to do it. Members of staff have families, needs and interests outside of pharmacy, believe it or not. Sometimes it can be an impossible challenge to beg, plead and negotiate with people, especially dispensary staff, to work at the weekend. It can also cost more to get people to come in and work at the weekend, especially if it is outside their normal working pattern.

I remember doing the odd Saturday locum, just myself and a counter assistant but, with the introduction of SOPs and training requirements, it would be very difficult to have 'occasional' dispensers like a counter assistant help to put orders away or do even a tiny bit of dispensing. Consequently you either have the overkill of having a dispenser on a Saturday or you risk overwhelming the pharmacist, especially if he/she is a locum.

Hands up if you've had a patient come in on a Saturday saying €I've just realised the surgery is shut today and... (insert standard request here)€. Normally it is a combination of €I put my repeat request in...€, €I've run out of...€, or €Could you have a look at....€, all of which creates extra work for the pharmacist.

The only means of external support on the weekend is the out-of-hours service, which can vary markedly in terms of effectiveness and accessibility as you move around the country.

I've had customers ask me why I don't open on a Sunday

I have lost count of the number of times I have been placed in a situation where I can help the patient because I know what they need, but simply cannot provide it because I don't have the tools at my disposal.

Urgent care

There is so much scope for a pharmacy urgent care service to empower us to deliver NHS care without having to make a more expensive referral to out-of-hours, a walk-in centre or, worse, A&E.

My CCG rightly wants pharmacy to be the first port of call for patients who have run out of their repeat medicines. Unfortunately it does not believe this should be a commissioned service, despite it reducing the number of calls to their out-of-hours service by 30 per cent. Where's the logic?

Public expectations of service providers have increased over the past few years, but I can't quite understand why people are not prepared to wait five minutes for their prescription when they'll wait 24 hours or more for a delivery from Amazon.

On a Saturday I find that people make no exceptions for the weekend. If you're open, you're open. Fifteen-item repeat prescription, complex malaria enquiry or a queue at the counter €“ it makes no difference.

I've had customers ask me why I don't open on Sundays. Clearly they've no idea what it costs to run a business, let alone a NHS pharmacy business. Yes, there are businesses, such as Boots and the supermarkets, that open on a Sunday, but they are primarily health and beauty retailers and secondary providers of NHS services. The income from OTCs and cosmetics is enough to combat the lack of funding for extended hours.

And, before they start sabre-rattling, I've no sympathy with 100-hour pharmacies. They knew what they were getting into when they put in their application.

It might just be that I am indeed getting grumpy, but I don't think we can put the genie of customer power back in the bottle, so we have to learn to adapt to thrive.

Canada deals with out-of-hours services with technology €“ vending machines with a camera and e-consultation booth. I really hope we don't end up going down this route because it will marginalise the importance of face-to-face human contact and therapeutic relationships built on trust and mutual respect. Ah, who am I kidding?

* Pen name of a practising community pharmacist. Alexander Humphries' views are not necessarily those of Pharmacy Magazine. Are customer expectations too high, especially on a weekend? Email pm@1530.com

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