Fintan Moore on the mixed bag of good and bad that came from the Covid crisis
Back in 2020 when the Covid Emergency struck, it was a very useful initiative by the powers that be to allow for prescriptions to be extended from the usual six months out to nine months. What was even more remarkable was the speed with which the change that got introduced – no delays with ‘stakeholder consultations’ or ‘review committees’ or any other complications. There was just a simple pragmatic instruction that the decision had been made, and for everybody to get on with it. It was like a wartime political action, which in the circumstances was fully warranted.
Now that the Covid crisis is regarded as over, it made sense that the emergency rules had to be regularised which is where we’re at. The result is something of a mixed bag. The option for doctors to write repeat prescriptions for up to a year is undeniably useful and will help in its intended objective to free up consultation time for both GP’s and hospitals. I’m seeing a rapid adoption of the twelve-month repeat by the likes of diabetic clinics and High Tech prescribers. The longer High Tech duration is especially welcome because up to now patients frequently had prescriptions expiring due to appointments being rescheduled.
So far so good, but where the waters get a bit murkier is with the six-month prescriptions that we now have permission to extend for up to a year. There is the immediate problem of the time required to evaluate whether or not an extension is appropriate. I don’t want the side-effect of taking pressure off the doctors to be a creation of extra pressure on me. In fairness, the previous situation had us doing emergency supplies of five days of medication and sending the patient to the doctor for a new prescription, after which we would have to dispense the remaining 25 days supply, so the difference in workload may often not me that significant. However there is still going to be some devil in the detail.
For instance the gov.ie website with information for the public about the change lists a few examples of cases where the pharmacist can extend a prescription, such as cholesterol tablets for ‘Tom’. According to gov.ie “Tom is 55 and has been taking statins daily to control his cholesterol for the last 7 years. He gets a blood test once a year to check his cholesterol. His GP gave him a 6 month prescription. After 6 months Tom asks his pharmacist if his prescription can be extended to 12 months. His pharmacist asks some questions, checks Tom’s blood pressure and reviews the information provided, then agrees to extend his prescription by 6 months and gives him the first month.” Unhelpfully, gov.ie doesn’t mention what questions the pharmacist has to ask. Similarly, we don’t get told where liability might fall if something goes wrong during the six-month extension period. And unsurprisingly, it doesn’t mention any payment from the government if Tom has a medical card. I don’t like to be negative about a well-intentioned and potentially useful change but there’s a bit left to be done here.
Making Britons Less Great
There’s a proposed initiative by the British government to cut the number of people on disability benefit due to obesity by providing them with the weight-loss drug, Mounjaro. The logic is that the cost of the injections can be justified because they should get enough of this cohort of people out of the obese weight range and down to a weight where they can be gainfully employed and thus no longer require benefits. It’s a fairly radical plan and seems more like something that would have been cooked up under a Tory minister rather than the leftwing-ish Labour Party. The Disability Benefit cost to the British exchequer is mammoth so there is probably a feeling that ‘something has to be done’ but the results of this will be interesting to see. I assume the people selected for Mounjaro will have to be volunteers but it’s not much of a leap to see a scenario in which benefits may be cut for those who refuse.
Unhelpfully, gov.ie doesn’t mention what questions the pharmacist has to ask
Do the OKI OKAY and Send it Round
I know most pharmacists seem to hate them, but I always had a grudging respect for the old OKI Microline receipt printers. They were indeed noisy, fiddly to adjust, and prone to jamming at the most inconvenient times possible but they always reminded me of the battered Massey Ferguson tractors you see on some farms that still work after fifty years despite being held together with baling twine. After a couple of decades service I recently decommissioned my old OKI when I upgraded my dispensary system to Touchstore and changed receipt printer. I put up a post on Pharmabuddy offering the newly retired machine free to any takers and was surprised at the number of people interested. It was gone within 24 hours. So if any of you similarly have a no-longer needed OKI taking up space in your storeroom it’s worth recycling it to somebody who’ll get some use out of it, even if just for spare parts.
Fintan Moore graduated as a pharmacist in 1990 from TCD and currently runs a pharmacy in Clondalkin. His email address is: greenparkpharmacy @gmail.com.
