Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
All the decisions in this dilemma have been made by the pharmacy owner who is not a pharmacist.
In your view does it matter that business decisions may have overruled clinical care?
“Absolutely. A healthcare professional, e.g. pharmacy technician or pharmacist should be involved in business decisions to provide an ethical and professional view on what is appropriate when delivering such services.”
“Pharmacy owner is still responsible for ensuring appropriate governance is in place and should have consulted with the superintendent pharmacist before changing existing services.”
“In certain ways, yes. The RP should be able to overrule and deliver medication if there is a clinical need. However, pharmacy is a business and should not lose money because some patients are lazy.”
“Yes, The Pharmacist is in charge of patient care and all decisions should be theirs.”
“Yes, but business decisions rule our ability to offer care daily.”
“If the pharmacy couldn’t survive the financial climate and had to close then that would put a lot of people at risk and their clinical care may suffer. The pharmacist may be able to offer more services with the money saved so the success of the business is important for clinical care.”
“Yes, there is a small proportion of patients who should get free delivery ie genuinely housebound.”
“There has to be a balance. A doctor wouldn’t see a patient if he wasn’t being paid. Why should we be liable for delivering medicine? It is our job to provide a pharmacy service. Delivering of medicines is a personal choice.”
“Sadly as community pharmacy is a business it doesn’t surprise me.”
“Yes, it always does matter. That’s how significant the conflict of interest almost always is with pharmacy. For example, is it right for a newly qualified store pharmacist to be dragged into a performance review for the drop in sales of OTC co-codamol because to quote “she’s been saying no to a lot of our customers and recommending just paracetamol or ibuprofen?”
“I think it matters. Non-pharmacist managers tend not to understand clinical needs.”
“The responsible pharmacist should be able to have the final say on individual cases – not on all.”
“Yes. Hopefully, a pharmacist would be putting patient care first.”
“Clinical care cannot take place at all if the business has to close and will be compromised if there are cutbacks to staffing or opening hours.”
“Yes- clinical care should always overrule business. Pharmacy isn’t retail/commercial first- the patient should always come first.”
This dilemma is hypothetical but have you experienced examples when the withdrawal of a medication delivery service has caused harm?
“No, but I hear tales of situations where this has happened.”
“No, but I’m not in a role that would see this either way.”
“Not personally as we currently still offer free delivery.”
“Not that I am aware of, but the pressure is not so great as to prevent us overruling it – but how long will the driver still be employed?”
“Not personally but we are still providing free deliveries.”
“No. Because if you’re withdrawing a service you should discuss with housebound patients. You should agree whether to charge patient or refer to another pharmacy.”
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.