Ultan Molloy reflects on the joys of ‘jamming’ with printers in the pharmacy and the concept of innovation in the profession
So we have a commitment from the HSE to move away from our present OKI blue paper printers for receipt-printing lauded as progress in the last week or so. When we are spending circa €500 on printer consumables, paper and ink presently, the prospect of spending more doesn’t feel or sound like it’s going to progress our bottom line in any significant way.
Ultan Molloy reflects on the joys of ‘jamming’ with printers in the pharmacy and the concept of innovation in the profession
I remember the ‘blue printer breaking down’ on me on a locum in Riverstown in Sligo, not long after returning from the UK. It was pension day, I wasn’t very familiar with the Irish schemes or the dispensing computer system and having accepted the locum, I assumed there would be at least one other staff member there with me.
Not the case. I nearly had a nervous breakdown. The repeated jamming of the OKI receipt printer was the icing on the cake. We have gotten to know one another over the years — the blue printer and myself, that is — with the usual cause of jamming being a tiny scrap of paper that has fallen into the working parts of the printer, which can be easily rectified. They’re relatively trouble-free once they’re set up and running, and shaken out and hoovered on a frequent basis. So I’m not feeling like I can yet celebrate this change as progress.
‘Innovation’ is a word that’s fired around a lot, and interchanged with the words ‘concept’ or ‘progress’, isn’t it? To innovate is to make changes to something that is established, especially by introducing new methods, ideas or products, according to our friend Google. It can be a costly journey in terms of time, finances, and other resources, and making changes for the sake of making changes can often be tantamount to folly.
We will see how the recently-established pharmacy working group gets on in due course. I’ve already given my tuppence worth on how extending prescription validity will lead to further disjointed patient care in the community, discrepancies in GP and pharmacy records, and is potentially dangerous for patients, given pharmacists are not usually privy to the clinical reasoning for the use of particular medicines on a patient-by-patient basis. We already have one surgery auto inserting ‘DO NOT EXTEND PRESCRIPTION’ as a default beside every item they prescribe, and I suspect others may follow suit, if they were to think it through, and want to keep track of what their patients are taking in real time, and want to have them back for regular and appropriate monitoring associated with the medicines they are on, and indeed for ongoing health screening.
I took a call on Saturday last from a lady who is looking to “find the pain points”, and innovate to offer a data-driven solution to community pharmacies as a new business. We spoke through medicine shortages, increasing costs across the board, skilled staff cover and HR, FEMPI cuts, as well as purchasing and maintaining margins. There are a number of pain points indeed, so I hope that she can find opportunities for us to address some of these, although I could not provide her with an idea of where to start that we hadn’t looked at already.
I’m sure I have blind spots, and wish her the best, as I’ve said, so we’ll see. “Can the communication between the GPs and yourselves be improved, for example?” she asked. I stopped myself from saying “What communication?”, although we aren’t doing too bad at all by some people’s experience in terms of communication with GP surgeries. I believe we are supposed to discuss prescription queries directly with GPs by law, and yet we have one lead GP in a local practice who “doesn’t take calls from pharmacies”, and so we have had to go through secretarial staff since 2007. We had so many errors coming across on prescriptions from another surgery many years back pre-Healthmail, that I took to pnc’ing them on the paper copies of the script one week (rather than spending time on the phone, where there was little appetite for correcting the patient records to prevent a recurrence), and faxing them back to the surgery with notes requesting them to update their records. We were subsequently admonished for “clogging up their fax machine”. Like that’s what I wanted to achieve, rather than accurate patient records for patient safety and care. Go figure. Ah, the joys of it.
Anyway, we’ll find out soon enough if the Department of Health has taken on board any of the recommendations in the IPU’s pre-budget submission. Talk about ‘negotiating’ with one hand tied behind one’s back.
While there are patients who can’t get a GP still, I suspect the number petitioning their local politicians because they can’t get a pharmacy is much lower. The number of pharmacies closing seems to have slowed down, prescription volumes nationally are increasing, and the cost of pharmacist cover seems to have reduced. It is difficult to predict the future, but the outcomes of the consultation (not negotiation) process with the Minister and Department of Health, and the recommendations of the MoH-appointed working group, will be interesting to see in the coming months. Hopefully some resourcing of the sector and some useful change and innovation in the sector will transpire.
Pharmacies and community pharmacists continue to be a valuable national resource on a walk-in basis, with thousands of people daily, when it can take weeks now to get a GP appointment. The sector appears to have weathered FEMPI and the turbulence of the last 10-plus years now. Let’s hope that the future brightens for the pharmacists joining the community into the future, and our communities can see and benefit from a well-resourced healthcare sector going forward.
