Pharmacists need better technology
Published: 3rd Dec 2009 12:38:13
Pharmacists have been shouldering an increasing number of challenges without any increase in staffing over the past decade.
In this week's Scrubbing Up, David Pruce, of the Royal Pharmaceutical Society, argues that it is time to give them some help.
Pharmacy is a secure and flexible profession.
Opinion polls consistently show that pharmacists are one of the most trusted professionals - coming second only to fire fighters in a poll for the Readers Digest.
So you would expect pharmacists to be a pretty contented lot.
Not so - many feel frustrated that their skills are under used and politicians agree.
Earl Howe, Conservative shadow health minister, said that "pharmacists represent our most under-utilised national resource in the delivery of services to NHS patients", echoing views across the political divide.
'Prescribing more difficult'
Pharmacists are experts in medicines and have more in-depth knowledge about them than any other healthcare profession.
The problem that the NHS faces is that the increased complexity of medicines and the huge potential for medicines to interact with each other makes prescribing more difficult.
Professor Sir Michael Rawlins, chairman of NICE, the NHS advisory body, drew attention to what he called "a serious problem in British medicinepoor prescribing".
It is estimated that 5% of all hospital admissions are the result of adverse effects of medicines.
All of this means that doctors need support from pharmacists to help them improve prescribing and patients need support to better understand and benefit from their medicines.
In hospitals, pharmacists are already an integral part of the clinical team and advise on complex medicine regimes.
However, most prescribing is started in the community and it is here that pharmacists could play an important role in optimising therapy and avoiding adverse effects.
'Seriously over worked'
Pharmacists in England and Wales offer a medicine use review service where a pharmacist will have a private consultation with a patient about their medicines.
It is valued by patients who have received it; pharmacists find it professionally satisfying and it improves patient's treatment.
A number of pharmacies also offer screening services such as cholesterol monitoring, help to stop smoking and flu vaccination.
The problem is that pharmacists are trying to do all of this on top of rising dispensing volumes.
The number of prescriptions has increased by two-thirds in the past 10 years with little or no change in staffing numbers over the same period.
Pharmacists are saying that they are seriously over worked with some working 10-hour shifts with no breaks during the shift - a situation which everyone recognises cannot be allowed to continue.
Pharmacists need to free up time from dispensing while maintaining accuracy.
Pharmacists are rightly paranoid about accuracy because the consequences of an error could be serious.
Gone are the days when pharmacists disappeared to the back of the dispensary to concoct a foul tasting mixture.
The majority of dispensing involves picking the right pack of medicines off the shelf and putting the right instructions on it.
It is a very manual task crying out for some form of automation.
It involves manually entering information from a prescription into the pharmacy computer in order to generate a label for the medicine.
An electronic prescription could be automatically transferred from the GP directly into the pharmacist's computer like e-mail and could be used to automatically generate a label.
Like most NHS IT projects the electronic prescription service is depressingly slow to deliver.
Even simple technology cannot be used in dispensing.
Supermarkets revolutionised check out throughput and accuracy with the use of bar code scanners.
But pharmacists cannot use them in dispensing because there is no industry standard bar code system in use across all manufacturers!
Dividing tablet packs
And finally, between a quarter and a third of all prescriptions require the cutting up of strips of tablets because the quantity on the prescription does not match the pack size.
If the prescription says 30 tablets and the pack contains 28 tablets, the pharmacist has to open up another pack and cut two tablets from it.
How much easier if the pharmacist could round up or round down the quantity to the nearest pack size.
Patients do not like cut up strips of tablets and for patients on long term medication, it would make no difference because it would even up over the year.
All of these solutions are not rocket science - they just need a will between all the stakeholders to make them happen (government, the pharmaceutical industry and the profession).
If this happens, pharmacists will be freed up to use their expert knowledge to further benefit patients.
Will change happen - let's hope so for everyone's sake.
Harvard CitationBBC News, 2009. Pharmacists need better technology. [Online] (Updated 03 Dec 2009)
Available at: http://www.manchesterwired.co.uk/news.php/491-Pharmacists-need-better-technology [Accessed 20th May 2013]
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