1. Udny Station Dispensing of Medicines Paul Johnston
Local Aberdeenshire Councillor for Udny Station
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2. DISPENSING DOCTORS REVIEW
The decision is not JUST about the personal serious difficulty. The relevant section of the regulations says:
Provision of dispensing services
15. - (1) A provider may secure the provision of dispensing services to its patients under
the agreement only if it is authorised or required to do so by the Health Board in accordance
with the following provisions of this paragraph.
(2) Where the Health Board is satisfied, after consultation with the area pharmaceutical
committee that a person, by reason of-
(a) distance;
(b) inadequacy of means of communication; or
(c) other exceptional circumstances,
will have serious difficulty in obtaining from a pharmacist any drugs, medicines or
appliances, other than Scheduled drugs, required for that person's treatment, the Health Board shall require or authorise the provider with whom the person is a registered patient to supply such drugs, medicines and appliances to that person until further notice.
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3. DISPENSING DOCTORS REVIEW
The review of dispensing GP practices is dependent upon the needs identified within a Pharmaceutical Care Services Plan.
That plan should determine the best locations for community pharmacies in relation to GP practice surgeries for the public to access medicines
The review group should recommend to the NHS Board, a consistent plan that allows for the inclusion of GP dispensing where there is no easily accessible Community Pharmacy
The review group should recommend a review to the PCSP that seeks a community pharmacy within 20 minutes walk equating to 1 mile or 1.6km as a maximum. Good practice would be to co-locate.
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4. DISPENSING DOCTORS REVIEW
The The review group should therefore conclude that as part of this review that where a GP surgery currently dispenses and there is not a community pharmacy within easy walking distance, then consideration should be given to dispensing under the regulation:
by reason of-
(a) distance;
and
(c) other exceptional circumstances,
and will have serious difficulty in obtaining from a pharmacist any drugs, medicines or appliances,
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5. DISPENSING DOCTORS REVIEW
Serious difficulty would be defined by a consistent reasonable distance of 20 minutes walk, I mile or 1.6KM.
Special circumstances should be defined in this case as
" Access to dispensed medicines at a GP surgery is considered appropriate in order to ensure adequate and safe cover at reasonable cost for all patients where a GP surgery is out with reasonable distance of a community pharmacy"
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6. The Review Group should recommend that:
Access to a car at the time of a survey is not a reason to assume a patient does not have serious difficulty.
The provision of medicines via a GP's back does not satisfy the regulation for those without access to a car or public transport.
The opportunities for community pharmacists to provide a service where GP practice surgeries do not have easy access to a community pharmacist should be published in the PCSP.
The clear consistent reasons for provision of GP dispensing should be in a revised PCSP.
That if cost of a full provision of dispensed medicines to those without access to car via a guaranteed delivery service falls below that of a provision of a GP dispensing contract, the NHS board should only then consider the suitability withdrawing GP dispensing from a surgery out with reasonable distance of a community pharmacy.
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7. DISPENSING DOCTORS REVIEW
In conclusion this is :
Consistant with regulations
Defensible in light of Judicial Review
Equitable with all patients – not just those with cars
Equitable for Pharmacist provision – transparency
Best value for NHS
Best consistant cover of Dispensed medicines and Pharmaceutical services
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8. DISPENSING DOCTORS REVIEW
Thank You
Any questions ?
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