From: "Jeff Green" <[log in to unmask]>
Sent: Sunday, December 05, 2004 1:37 PM

> Paul,
> > As you may guess, the local
> > pharmacists are not happy about this one either.
> I suspect that you can guess why not ;-)
> Paid on a per item basis - you are at a stroke about to half their income
from  your practice  and increase their
> stockholdings to cover the larger amounts on scripts.

> Subject to how dependent the pharmacy is on your surgery perhaps several
hundred thousand pounds has been wiped off the value
> of the pharmacy.

Yes Jeff and if there had been more sympathy for the effect on the practice
of pharmacist encouragement of patients & carers to demand weekly scrips to
fund a non NHS service there might be more interprofessional sympathy.
Killing the goose that lays the golden egg comes to mind. Many practices are
at the end of their tether and trying to find workload efficiencies to free
time for the QOF (for example). Once a patient is stable and only coming to
see me every 6 months what is the rationale for 28 day repeats since the
computer can help us with control by indicating the next due date? In my
practice this costs the equivalent of £130 in locum costs (conservative
estimate) every single day with staff costs on top of this - I estimate a
quarter time receptionist equivalent - and we too are moving to 56 day
repeats for normal patients under 70 or even 84 if on less than four items.
We do HRT and OC for 26 weeks. We still prescribe blister packs on monthly
repeat since we think it is impractical for patients to have dozens of cards
all over the house. Maybe the innovative pharmacist will approach the
practice and offer to help manage the repeat prescribing system?


> OK we understandably have different viewpoints - but I suspect that those
best able to see the balance are dispensing
> doctors - so could we have a dispensing doctors view on 28 days scripts in
general and 7 day dosette box scripts?

The issue is different for dispensing doctors as you know because they can
offset costs with income not available to prescribing doctors. Last time I
looked the per GP difference in profit between dispensing and non-D docs was
£10,000 per annum and rising. My nearest & dearest was a dispensing doctor &
is now the MD of the pharmacy attached to the practice. Financially speaking
the pharmacy seems to be a better return than the dispensing.

Fay