dodgy prescribing dilemma

[bobbin]

While the DoH is looking at the price of specials, can they also look at the packs of 32 paracet/co-cod/co-dyd/tramadol30s/30mg dihydros etc etc as I am fed up of juggling a dozen boxes plus for 2 items!!! More boxes means more room for error like splits.

Whilst we're at it, let's stop doing everything that generates income for the pharmacy! Might have to look into reduced hourly rates for locums though. Money doesn't come out of thin air Luke, it has to be made, and this is one way of making it. If the DoH didn't want pharmacies to use 32s, they would remove them from the Drug Tariff. I don't enjoy dealing with 32s either. Unfortunately, it's a virtual necessity due to Category M. Any pharmacy which doesn't take advantage of it will lose out on a *lot* of funding.

[cozo]

While the DoH is looking at the price of specials, can they also look at the packs of 32 paracet/co-cod/co-dyd/tramadol30s/30mg dihydros etc etc as I am fed up of juggling a dozen boxes plus for 2 items!!! More boxes means more room for error like splits.

The DuH have done that on purpose. Nothing to look at...

Sorry to sound the stupid one. Please may someone explain why the DuH have done this?

[bobbin]

While the DoH is looking at the price of specials, can they also look at the packs of 32 paracet/co-cod/co-dyd/tramadol30s/30mg dihydros etc etc as I am fed up of juggling a dozen boxes plus for 2 items!!! More boxes means more room for error like splits.

The DuH have done that on purpose. Nothing to look at...

Sorry to sound the stupid one. Please may someone explain why the DuH have done this?

All the above listed products are in Category M of the DT. Cat M is the DoH's mechanism for controlling pharmacy buying profits. In some cases, using one Cat M pack size is more profitable than another. The DoH knows this - they set up Cat M this way. Clearly, the DoH expects that pharmacies will use the most profitable pack sizes for dispensing. Any pharmacy which chooses not to do so will lose out on their share of the negotiated profit. This is why all of the major mutiples and many independents use small pack sizes for some products.

(This part is not directed at you, but just a general point).....

I appreciate that this is a forum for locums and it seems that some locums have no interest in the profitability of the pharmacies that employ them. Interestingly, it's often the same locums who talk about demanding high hourly rates. I find this rather strange. I do not know where they think the money is coming from! Pharmacy is an expensive business and there are many things to be paid for. We all want to provide a good service to customers but this just isn't possible without adequate income.

[cartrefeira]

I think we all have an interest in the financial health of pharmacies -- we are all only too well aware that locum rates have hardly altered in the last three to five years while other health professionals have done very well (I know it's supply and demand, we don't need to debate that again).

What I am unhappy about is that so much of the net profit of pharmacies depends upon Arthur Daly style dodgy methods.

Bob Gartside

[bobbin]

I think we all have an interest in the financial health of pharmacies -- we are all only too well aware that locum rates have hardly altered in the last three to five years while other health professionals have done very well (I know it's supply and demand, we don't need to debate that again).

What I am unhappy about is that so much of the net profit of pharmacies depends upon Arthur Daly style dodgy methods.

Bob Gartside

What we've seen since the New Contract is money taken out of dispensing, allegedly to be put back into pharmacy through 'services' - which, for a variety of reasons don't always materialise.

I would much rather dispense paracetamol out of 100s than 32s, but we have to do what keeps the pharmacy going. Working for an independent, we do our best to maintain the viability of the pharmacy...... in spite of many recent difficulties that we have encountered.

My dream for pharmacy is an end to the domination by the multiples. I much preferred things before these companies (and their associated wholesalers) became so powerful.

Bobbin

[Suki Lalla]

We all want to provide a good service to customers but this just isn't possible without adequate income.

Dump the PSNC ! and get better negotiators

[roper]

If the smaller quantities of painkillers were ever prescribed then the 32 or 30 packs would be necessary to ensure that everone got a PIL. It is just frustrating to see this situation so often and then dispense small quantities of other drugs out of large pack sizes where the only PIL is stuck securely to the original container and you simply can't photocopy it! I know we are now able to download them but it is a lot of hassle and sometimes they look like a book. I had a complaint made against me for inadvertently dispensing 6 trimethoprim without a leaflet. Packs of 6 are available but the shop only used the 14 size and the GP often gave a 3 day course!

[LocumLuke]

I must admit, I find all this Cat.M confusing!
Why did the DoH not make the 100 pack the most effective option?

[bobbin]

Packs of 6 are available but the shop only used the 14 size and the GP often gave a 3 day course!

Annoyingly, the 6-tab pack isn't in the Drug Tariff. It would be useful if it was. As it stands, only the 14-pack is listed in the DT and the packs of 6 are actually more expensive than the packs of 14. We tend to photocopy leaflets if we get a quiet moment, which is rare.

[bobbin]

I must admit, I find all this Cat.M confusing!
Why did the DoH not make the 100 pack the most effective option?

Because that would be far too easy!

[El-Loco]

Dump the PSNC ! and get better negotiators

Who? Spell it f*cking out for us if you have an answer.

[Suki Lalla]

Dump the PSNC ! and get better negotiators

Who? Spell it f*cking out for us if you have an answer.

Now now !! ... the EPB and PDA should be central to these negotiations ... now that the dual role is no more there is ZERO reason why the EPB and PDA cannot be involved ..

It is pharmacists that provide the service .. NOT PHARMACIES ... bricks and mortar in the age of the knowledge economy are worth trite ... without the brains to operate them what would swiss bwankers do ??

The EPB needs to set up a specialist unit INDEPENDENT of the PSNC which focuses solely on renumeration and workload issues for members AND contractors

[El-Loco]

The EPB needs to set up a specialist unit INDEPENDENT of the PSNC which focuses solely on renumeration and workload issues for members AND contractors

Sorry Suki but I do get annoyed with rhetoric in the absence of positive suggestions.

So you reckon the EPB and the PDA should get involved with remuneration and workload negotiations.

O.K. but there are two problems as I see it.

1) It has yet to be universally accepted that these ARE two key issues
2) Neither IMHO has the muscle without considerably more support from their members.

[EAST1]

Suki Lalla.

Given that monopsonistic purchasers love nothing more than a fragmented supplier market, on what grounds do you believe that around 11,000 individual contractors can negotiate a better deal than the current market model which is led by multiples, who must have some clout in negotiations (regardless of who is doing the negotiating for us - PSNC, EPB, PDA) ? One contract is a nice idea from a professional standpoint, but we could get seriously bashed by the DoH from a financial standpoint and be worse off than we are now.

[cartrefeira]

Suki Lalla.

Given that monopsonistic purchasers love nothing more than a fragmented supplier market, on what grounds do you believe that around 11,000 individual contractors can negotiate a better deal than the current market model which is led by multiples, who must have some clout in negotiations (regardless of who is doing the negotiating for us - PSNC, EPB, PDA) ? One contract is a nice idea from a professional standpoint, but we could get seriously bashed by the DoH from a financial standpoint and be worse off than we are now.

Ever since I became an LPC secretary in 1979 I have heard this argument advanced by independent members of PSNC and it is, quite frankly plain wrong.

There is a profound difference between independents and multiples and it is that multiples buy at very much better terms than independents, very much better terms. Hence their interest in payments linked to medicines costs and their relative lack of interest in dispensing fees. What is perhaps surprising is that the independent members of PSNC go along with this -- perhaps its because each of them will tell you that, as a personal favour, they get individual special terms from their (multiple owned) wholesalers which are not available to anyone else. This information is always passed on in confidence because no-one else gets such terms. Poor saps.

Bob Gartside