Closures: Pharmacist concerns about patient harm and impact on NHS

The PDA is highlighting concerns about avoidable pharmacy closures where contractors seemingly breach their agreement with the NHS and opt to close rather than engage available locums, thus denying patients the access to a pharmacists and pharmacy which the NHS have promised to provide.

Wed 18th August 2021 The PDA

As part of the PDA efforts to address the issue of avoidable closures the PDA is publishing this example which demonstrates what is sadly becoming a regular experience for pharmacists, patients and their communities, due to the decisions and actions of some employers.

A pharmacist* recently wrote to the NHS:

 

I was working in the XXXXXXXXX pharmacy today (Saturday) when a patient phoned looking for some medication as he had run out and his regular Pharmacy, XXXXXXXXXXXX, was closed.

According to staff and a quick google search, that pharmacy should have been opened from 9am to 1pm. Unfortunately, this became a recurring theme for the remainder of my day, and I lost count of the times I had to have the same conversation and listen to complaints.

A patient who receives weekly Diazepam missed his collection from that pharmacy yesterday and found them closed today. He phoned me and I advised he speak to NHS24. He managed to speak to a nurse prescriber who did not believe the pharmacy was closed, as NHS24 was not notified.

Pharmacies are meant to help reduce pressure on NHS services, but the opposite has resulted. One pharmacy closure resulted in extra calls to NHS24 and avoidable issues for OOH prescribers. In the end I had to complete a supply of Diazepam against an email prescription to upkeep patient care. This is merely one example from many.

Given the circumstances and due to a lack of concrete information I had no choice but to refer people to NHS24 or call for ECS access to see to their medicinal needs. This added to my workload in a Pharmacy that was already behind schedule and short-staffed.

I completely understand and empathise that in some circumstances a closure is unavoidable, however, the number currently being discussed and reported in Scotland is extremely worrying. What’s worse is many companies only report to their own head office and not the health board.

The most common reasons used to justify closures is a shortage of Pharmacists or lack of support staff. As a multimillion-pound large company with a vast amount of resources, XXXXXXXXX should have no issue sourcing and training pharmacy support staff. There is also no shortage of Pharmacists.

If Pharmacists do not want to work for companies that create high-risk environments, then that is their choice. I also receive emails advertising locum shifts and have not seen any for Saturdays in that pharmacy which makes me wonder if there is any effort to source cover in order to provide adequate provision of pharmaceutical services.

Companies should be penalised for any breach in contract. It seems this Pharmacy in particular is known to close regularly from what I gathered from both staff and patients.

As I work all over Scotland, I receive community pharmacy updates from numerous health boards. Many have recently contacted all contractors to remind them of the process to report unplanned/planned pharmacy closures.

I asked numerous patients affected by the closure if there was any signposting on the Pharmacy shutters to indicate closure or what Pharmacies are nearby, but there was nothing.

I would be grateful if you could look into the reason for this closure. I am hopeful that going forward, companies will prioritise patient care and ensure an adequate level of pharmacy provision is in place in line with health board requirements. This will ensure NHS24 services are not overwhelmed unnecessarily and the most serious of cases are dealt with ASAP.

 

*Details that could identify patients or the pharmacist have been removed

The situation described above is also being experienced by other pharmacists as they too must pick up the activity displaced by those who decide to close. In addition to their existing workload these individuals are caring for additional patients as best they can, but this is not always fully possible and of course not every patient may consider contacting, or be able to get to, an alternative pharmacy.

This issue of avoidable closures is increasingly being discussed on social, print and broadcast media and this could therefore become a significant issue for the public, politicians, and taxpayers.

If it is shown that contractors could be open, but decide to close, and also fail to notify the NHS in line with their contract, it will undoubtedly damage the reputation of pharmacy and pharmacists. This risks undermining the great work being done my many in the sector to help pharmacy reach its full potential in the health system.

The PDA continues to call upon employers, and their representative bodies to take this situation seriously and honour the NHS Contract which they have committed to deliver.

Meanwhile, in order to help the work to address this issue, the PDA is asking pharmacists to help collate information about when and where these closures are occuring, using an online tool.  This notifies the PDA of the details; contractors are separately obliged to notify the NHS.

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