Monday, February 15, 2016

Pharmacists were meant to be the face of the NHS - but now our jobs are at risk

Pharmacists have a massive impact on patient care, but proposed government cuts of 6% to funding could mean closures, job losses and reduced pay
am a community pharmacist. In an average week I carry out a legal check on hundreds of prescriptions, and in depth clinical checks on upwards of 1,500 medications. I give flu jabs, emergency contraception, review prescriptions and how patients use their medication as well as provide whichever other pharmaceutical services the NHS currently deems cost effective. 
I stand up for 10 hours a day, either hunched over my work desk or running from patient to patient. All this with only a quick 20 minute lunch break to forage for some sustenance, while still having to check prescriptions. Somehow, between rushing from task to task, pharmacists are able to have a massive impact on patient care – yet the chances are that the patient will never know. 
I have lost count of the number of times that I have been passed a prescription that has been incorrect, or even harmful. I’ve uncovered so many mistakes in consultations with patients that I begin to wonder what prescribing doctors and nurses actually do.
I’ve witnessed one patient, when asked to demonstrate inhaler usage open their mouth and use the device to spray their outstretched tongue. The patient had been using the inhaler completely incorrectly for more than five years and had been reviewed by their GP many times without it being rectified. More than once, I’ve seen a prescribed drug dosage which could have proved fatal if it had made its way to the patient. Usually these patients are the very young or the very elderly. Yet when faced with clinical errors, can the pharmacist take action? No, we have to phone the GP surgery and wait on the line for 15 minutes like everyone else.
We have an impact on patient care, but it feels like the public don’t know or care. In an all too common week, I have had a drug misuser threaten me, I’ve been screamed at by an elderly woman for not being able to source a discontinued medication and I’ve been called incompetent because I’ve taken longer than 41 seconds to complete a clinical check and hand out a prescription to a patient. Patients demand an instant service in a pharmacy when they’re willing to wait for a hospital or GP appointment.
What the public see when they look from the outside is a person in a supply role. The prevailing feeling I get is that I am there to order medications and then pick them off the shelf before putting them in a nicely folded bag. I am a fully fledged healthcare professional; tie, master’s degree, professional body et al. I was educated and trained to provide a clinical service, which I do – helping many patients further understand their medications and potentially saving them from harm.
This disparity between public perception and the actual job role has sparked a much larger fire. Recently the government managed to slip through a proposed 6% cut in pharmacy funding. This 6% doesn’t sound like much until you realise it equates to £170m. That is a gargantuan chunk of cash which will potentially mean pharmaceutical services, the ones which use my clinical expertise and benefit patients, may be cut. It will probably mean pharmacy closures, job losses and worsening pay for those of us left in the sector. While it is unclear what exactly will change, we have had some grim examples of the future – pushing pharmacies towards a supermarket service model seems a strong contender for saving the government money as well as devaluing our profession. If funding for services is lost, we will face a self-fulfilling prophecy – we are seen only as suppliers of medication, so we will become just suppliers of medication and won’t be able to provide the service we currently do.
What hurts more is that the media, public and even other pharmacists have seen this proposal passed with little more than a bat of their eyelids. Remember thefurore when junior doctor pay cuts were proposed or when nurse bursary cuts were put forward? At one point we were promised that we would be the new frontline face of the NHS yet here we are forsaken by the government, overworked day to day and often contemplating our fast ebbing job security. So next time you use your local pharmacy, please spare a thought for the pharmacist behind the counter. They’re probably stressed, tired, hungry and scared for their future.
There is a petition to stop cuts to pharmacy funding and support pharmacy services that save NHS money.
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