Brexit - Creating a Cuntocracy - Now with 4d chess option

I really think that is pretty ill thought out and highly unlikely. In no way do current powers allow pharmacists to alter prescribed medicines or treatments as these are set on clinical need rather than availability by the GP.

Pharmacists would not have access to the individuals medical records to be able to assess impact of altering GP prescribed treatments and therefore would be unsafe as a practice/ policy.

What they could do between them though is reduce the stockpiling of medicines which pharmacists benefit from currently, and reduce the prescription of ineffective treatments and over the counter meds.

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I was surprised that they had the right to overwrite a gp

Saying that if there is no deal and certain medicines are sparse,all bets are off

How will they allocate what parts of the country gets what?

Based on clinical need, not based on the opinions of pharmacists.

The issue is probably about creating buffer stocks if we can no longer operate JIT due to border transaction lead times etc, rather than actual chronic shortages of meds.

At least I will be spared the worst effects of no-deal Brexit. As a type 1 diabetic, Iā€™ll probably be dead in the first couple of weeks. :roll_eyes:

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And that folks is how weā€™re going to save the Ā£350m a week on the NHS :skull::rofl:

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So far I have stockpiled 3 monthsā€™ medication

I just assumed that it would be as simple as the pharmacist saying ā€œIā€™m sorry, I know the GPā€™s prescribed 56 days worth of drugs for you, but given the shortage Iā€™m going to have to reduce that to 28 days. Come back in a few weeks by which time things should be a bit better organisedā€.

VB

North South divide and fuck Scotland and Wales.

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The fuckers could do that now and save us all a fortune, and in three health systems thatā€™s exactly what Iā€™ve managed to make them do.

Wouldnā€™t save me a fortune. Itā€™s not very common for type 1 diabetics to suddenly get better. So all it would mean would be twice as many trips to the pharmacy, burning petrol, away from work, stuck pointlessly in the traffic and then the queue in front of you, etc, etc ā€¦

VB

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Was thinking the same, inevitably that means more ball ache for the sick and their carers.

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Yes we would all be better off if those with one or more LTCs snuffed it through lack of meds :wink:

Maybe not in your case, and GPs are allowed to set repeat frequency etc for just those circumstances. But in general pharmacies dictate the repeat frequency and make a lot of money by doing so. As a consequence there are lots of safety issues with stockpiled and out of date medicines.

Stronzetto has the concern. Glue shortages will not be good for anyone.

Donā€™t let Mrs May hear you saying that :wink:.

Iā€™d be interested to know what the trade-off is between the cost of unused drugs when patients get better or go dead and the cost of all the process (GP time, pharmacy time etc) involved in handing the tablets out a few at a time. It has the whiff of one of those situations where itā€™s easy to measure the former, so we do and then we bleat about it, and itā€™s hard to measure the latter, so we donā€™t and just pretend it doesnā€™t exist. When I was at work I gradually got a bigger and bigger swarm of bees in my bonnet about process costs. People with nothing better to do would interrupt me with silly-assed questions and demands for me to do stuff with zero apparent understanding that my time cost money.

VB

You see, you should have been an accountant.

70% of the health & social care budget is spent caring for people with one or more LTCs. The growth in the number of patients in this cohort is estimated to be c Ā£4bn a year (Kings Fund).

I understand only too well the process time challenge you raise - spent most of my working life in various sectors trying to square that one appropriately.

In this case GPs (unless they are also providing onsite pharmacy) overwhelmingly agree with me. There are fairly simple methods of ensuring that the limited and expensive time of GPs isnā€™t spent on admin or non value add processes. GPs used to manage this quite happily until pharmacies began to intercede and offer the repeat service directly to patients. Its only when you present the total case in terms of impact that GPs have woken up to the downsides of something that has rather crept in by stealth. Especially when you have some herbert like me giving them all manner of shit about their overspent prescribing budget and exposing their lack of control.

Donā€™t get me wrong, pharmacies do offer a great service, particularly for those who are housebound, lack mobility etc, but what has happened is this level of service has become the norm, even when not required, which is then an overhead which all of us bear, and which affects access to expensive drugs and treatments.

I donā€™t think pharmacists have any options when it comes to filling a prescription.
I remember taking a script to the ā€˜chemistā€™ (Why do we call them that?) and the pharmacist telling me he could not fulfill it as the doctor had specified a brand name and he only had the (much cheaper) generic option. So i couldnā€™t get the cheaper version of the same drug but had to either wait a day for the expensive one to come in or take the script elsewhere.

Had the same experience too.

Iā€™ll check with my GP and if I can get the same level of convenience with them that I currently have with Boots then Iā€™ll revert to them. But when I last did it that way round (years ago, admittedly) I remember having to go in person to my GP, at the other end of town, and then stand in the single queue which dealt with everything just to pick up my paper prescription. A 20-minute wait was quite typical. And I couldnā€™t order my next prescription at the same time as picking up the current one, which I can at Boots. And I still had to go into Boots and join their (shorter, usually) queue to collect the drugs. And Boots is a lot nearer. So getting my prescriptions via the pharmacy more than halves the effort I used to have to put in.

I think we might be slipping into the ā€˜not patient-centredā€™ trap again here. The NHS might be taking the view that if I am well enough to trudge up to the GPā€™s, stand in line, spend my time to save theirs, spend more time at the pharmacy etc, etc then thatā€™s fine. Because their time is precious and my time is, letā€™s face it, worthless. I wonder why the better level of service has ā€˜become the normā€™ ā€¦ ?

VB