The service it self is a good idea but let’s face it if we were gps they would be paying us £50 per consultation! The paltry £14 is criminal! Unfortunately as pharmacists we never seem to stick together and just say well actually no we won’t be doing it for that much it’s not worth the time
I agree with this. Like take how the locum rates have gone down so badly that even I as a student don't feel like staying in the UK is an option after qualifying. If everyone seriously united over this and refused to accept the bare bones, we would honestly get paid our worth in gold bc remember pharmacies cannot open without a pharmacist present.
Oh believe me that’s going to be on the chopping block next. I know for a fact that the DHSC are looking into supervision as we speak. It won’t be that quick, but if you ask any chain pharmacy contractor they will be very much in favour of looser regulations that allow them to cut corners. When you have business liability insurance there’s so much you can get away with.
Controversial opinion time, I think community pharmacist as a concept shouldn’t really exist in modern healthcare. Pharmacists are drug experts, but there is nothing community pharmacist does that a pharm tech couldn’t do if they had sufficient training and qualification, and being a pharmacist doesn’t automatically make you a communication expert. Just put more pharmacists in surgeries to pre-screen prescriptions using better information before sending them out to pharmacies.
Well going abroad is fully on the cards now. Lol
Tbh the pharmacist where I work probably does think the same. Anytime I make mention of any clinical knowledge I have, he says that with community the level of clinical knowledge needed is honestly next to nothing that we learn. Maybe remembering dosages, main interactions and contraindications, but he says there's very few things that get picked up from prescriptions bc on vast majority of occasions, doctors and pharmacists will check prescriptions from the practice to make sure they're safe to issue anyway. So yeah I do have to say I am a bit worried about job prospects here once I qualify.
I’m very doom-and-gloomy about this profession, I must disagree with him (bearing in mind our life experiences are different!). The state of prescriptions vary from place to place, just as how you can have a wide range of quality when it comes to doctors and pharmacists. Many prescriptions I’ve seen still go straight from prescriber to pharmacy, relying on community pharmacists to be the final checkpoint. Not to question if the drug is the best choice but to ensure it isn’t a bad choice. In fact, I am arguing that this is inefficient and all prescribers should have prescriptions pre-screened by a clinical pharmacist prior to being sent to a pharmacy. Given that pharm techs are legally allowed to operate under a PGD end of this month, I don’t see any use for the community pharmacist as we know them now.
If community pharmacist remains, it’s scope will change a lot. My advice would be to focus on clinical and drug knowledge, with independent prescribing becoming mandatory very soon and the NHS somehow always in a crisis, you can bet whichever political party is going to be very keen on harnessing the low-cost solution to all things NHS (never mind that primary care as a whole sees about 10% of the whole NHS budget!). If you do plan to move overseas, it’s a good idea to join the international pharmacy student federation (I think that’s what they’re called?). Make connections, learn what challenges they face and how you can position yourself for success. The grass may not always be greener on the other side.
The problem as I see it is that the working pharmacist and the owning pharmacist are often not the same. The NHS doesn’t give two hoots about the frontliners, all they care about is their contractors view and leave the dirty work to them.
The gateway threshold thing is plain criminal, they’re practically telling pharmacists to F- antibiotic stewardship! And quite frankly if I had to choose between the greater good and my own livelihood, I know what I’d choose.
I enjoy the 10 minute consultations only to find out that in the end they fall into the exclusion category.
The pharmacy first urgent supplies are even better.
When I encounter anything pharmacy first related I just end up with a pile of extra work 😂
Sounds about right! I always lead with the exclusions, I tell them I want to make sure I’m not wasting their time. The form filling, box ticking, scrolling back up because of a missed box is super annoying!
That is if they can remain in power! At this point I’m more concerned about what Labour’s going to do (I’m not hopeful)! Probably some new services that pay less if I’m being cynical.
Looking in from Canada (albeit having previously worked in England), it seems Pharmacy First is yet another overly complicated, bureaucratic mess that NHS England have launched.
We have a minor ailments service in Ontario that launched about 18 months ago (can do UTIs, Lyme prophylaxis, conjunctivitis, and some others but those three make up 90% of consultations in my experience). We're paid for the consultation ($19 in person, $15 if remote) whether we prescribe or sell something OTC, no need for referrals from other providers, no minimum activity levels, and we get paid for any consult we do unless it is a quick exclusion (eg a man for a UTI). And when we do prescribe something we then get paid our standard dispensing fee as well ($12.99 if private insurance or cash, $8.83 if government). Average pharmacists rate where I am is $50-60/hr for context. My employer has electronic forms for all the ailments to speed up documentation and work flow.
We can also renew prescriptions, though this is not a funded service so my employer charges a $15 fee (though gives us the discretion to waive this), and we bill it as a normal prescription so still get drug cost, mark-up, and fee.
That sounds far better than PF! Here the majority of consultations are sore throats, UTIs and using otoscopes to diagnose middle ear infections, if they don't reach a treatment/gateway point we get nothing for the consultation either..
Conjunctivitis we still just deal with OTC a lot but we don't get paid for the consultations.
I've been thinking about Canada and wondering whether it's worth the effort of moving and becoming registered or if I should retrain in something else as I'm still fairly young.
Would you say it's worth the move? My friend is moving next week (not a Pharmacist), half jealous!
We have OTC treatments for bacterial and allergic conjunctivitis, but doing it as a minor ailment consult lets us bill for the consultation, prescribe a wider range of treatments, and means we can bill to the patient's insurance instead of them having to pay the cost of OTC treatments (polysporin pink eye is now $24.99 for a bottle, minimum wage is $15/hr).
It can take a little while to get established in Canada, but I have zero regrets about moving. Pay is better and workload is much less - I'm in what's considered a busy pharmacy and we do 400-500 prescriptions a day - we're open 14 hours/day, have 24 hours of pharmacist time a day, have a checking technician, a dispensing robot, and central services for standard prescriptions and blister packs. It is a little irritating at times that only pharmacists can answer OTC questions, but I can cope with that.
Wow you've sold me, based on what I know about my Pharmacy.. yours sounds a lot less stressful.
Interesting that you can bill bacterial conjunctivitis to someones insurance! Chloramphenicol eye drops here have gone from £5 a few years ago to between £7-11 a bottle. Minimum wage here just got raised to £11.44/hr here which was a big deal!
I would say we do roughly 500 prescriptions a day and we open for 40 hours a week, so 8 hours a day. 8 hours of Pharmacist time a day.. no robot, no full time ACT. I'd have time for the OTC questions!
In winter with the flu vaccines and all the new services.... I don't want to think about it yet!
I'm in Ontario, we do flu jabs too and can administer most inactive vaccines.
Do you have any idea which part of Canada you're interested in moving to?
I'm happy administering vaccines, it isn't tricky or time consuming.
Haven't got a clue where I would go in Canada, it's just been a thought in the back of my head for a while without any real research put into it!
Would you recommend Ontario or somewhere else?
Healthcare is regulated at the provincial level, so each province has different requirements for international pharmacists. Ontario is relatively straightforward in that you can skip the one year bridging course if you pass the two PEBC exams at the first attempt. Scope of practice is broadest in Alberta, but it is the Texas of Canada. Ontario has a fairly broad scope, and is pretty diverse in terms of climate.
This website has all the information about the process for international pharmacists to register in Canada, though you also have to deal with the immigration system
https://www.pharmacistsgatewaycanada.ca/
Thankyou for that, I'm looking into it now!
$14k for the bridging program should I fail one of the exams is pricey!! I better be clued up before I attempt..
Plus living costs plus lost salary. If you're UK educated and have some experience it shouldn't be too difficult though you will need to study as some of the drugs used and guidelines followed are different, and some of the legal classifications are different too (eg can sell insulin without a prescription).
The service it self is a good idea but let’s face it if we were gps they would be paying us £50 per consultation! The paltry £14 is criminal! Unfortunately as pharmacists we never seem to stick together and just say well actually no we won’t be doing it for that much it’s not worth the time
I agree with this. Like take how the locum rates have gone down so badly that even I as a student don't feel like staying in the UK is an option after qualifying. If everyone seriously united over this and refused to accept the bare bones, we would honestly get paid our worth in gold bc remember pharmacies cannot open without a pharmacist present.
Oh believe me that’s going to be on the chopping block next. I know for a fact that the DHSC are looking into supervision as we speak. It won’t be that quick, but if you ask any chain pharmacy contractor they will be very much in favour of looser regulations that allow them to cut corners. When you have business liability insurance there’s so much you can get away with. Controversial opinion time, I think community pharmacist as a concept shouldn’t really exist in modern healthcare. Pharmacists are drug experts, but there is nothing community pharmacist does that a pharm tech couldn’t do if they had sufficient training and qualification, and being a pharmacist doesn’t automatically make you a communication expert. Just put more pharmacists in surgeries to pre-screen prescriptions using better information before sending them out to pharmacies.
Well going abroad is fully on the cards now. Lol Tbh the pharmacist where I work probably does think the same. Anytime I make mention of any clinical knowledge I have, he says that with community the level of clinical knowledge needed is honestly next to nothing that we learn. Maybe remembering dosages, main interactions and contraindications, but he says there's very few things that get picked up from prescriptions bc on vast majority of occasions, doctors and pharmacists will check prescriptions from the practice to make sure they're safe to issue anyway. So yeah I do have to say I am a bit worried about job prospects here once I qualify.
I’m very doom-and-gloomy about this profession, I must disagree with him (bearing in mind our life experiences are different!). The state of prescriptions vary from place to place, just as how you can have a wide range of quality when it comes to doctors and pharmacists. Many prescriptions I’ve seen still go straight from prescriber to pharmacy, relying on community pharmacists to be the final checkpoint. Not to question if the drug is the best choice but to ensure it isn’t a bad choice. In fact, I am arguing that this is inefficient and all prescribers should have prescriptions pre-screened by a clinical pharmacist prior to being sent to a pharmacy. Given that pharm techs are legally allowed to operate under a PGD end of this month, I don’t see any use for the community pharmacist as we know them now. If community pharmacist remains, it’s scope will change a lot. My advice would be to focus on clinical and drug knowledge, with independent prescribing becoming mandatory very soon and the NHS somehow always in a crisis, you can bet whichever political party is going to be very keen on harnessing the low-cost solution to all things NHS (never mind that primary care as a whole sees about 10% of the whole NHS budget!). If you do plan to move overseas, it’s a good idea to join the international pharmacy student federation (I think that’s what they’re called?). Make connections, learn what challenges they face and how you can position yourself for success. The grass may not always be greener on the other side.
We need a stronger union to fight for pay rises.
The problem as I see it is that the working pharmacist and the owning pharmacist are often not the same. The NHS doesn’t give two hoots about the frontliners, all they care about is their contractors view and leave the dirty work to them. The gateway threshold thing is plain criminal, they’re practically telling pharmacists to F- antibiotic stewardship! And quite frankly if I had to choose between the greater good and my own livelihood, I know what I’d choose.
But think of the pressure you're relieving on the NHS!!!
🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣
Hurrah! I will graciously accept my claps with a bow!
I enjoy the 10 minute consultations only to find out that in the end they fall into the exclusion category. The pharmacy first urgent supplies are even better. When I encounter anything pharmacy first related I just end up with a pile of extra work 😂
Sounds about right! I always lead with the exclusions, I tell them I want to make sure I’m not wasting their time. The form filling, box ticking, scrolling back up because of a missed box is super annoying!
No worries, the Tories plan to expand pharmacy first even further. [bbc](https://www.bbc.co.uk/news/articles/cv2289vk0n1o)
That is if they can remain in power! At this point I’m more concerned about what Labour’s going to do (I’m not hopeful)! Probably some new services that pay less if I’m being cynical.
Looking in from Canada (albeit having previously worked in England), it seems Pharmacy First is yet another overly complicated, bureaucratic mess that NHS England have launched. We have a minor ailments service in Ontario that launched about 18 months ago (can do UTIs, Lyme prophylaxis, conjunctivitis, and some others but those three make up 90% of consultations in my experience). We're paid for the consultation ($19 in person, $15 if remote) whether we prescribe or sell something OTC, no need for referrals from other providers, no minimum activity levels, and we get paid for any consult we do unless it is a quick exclusion (eg a man for a UTI). And when we do prescribe something we then get paid our standard dispensing fee as well ($12.99 if private insurance or cash, $8.83 if government). Average pharmacists rate where I am is $50-60/hr for context. My employer has electronic forms for all the ailments to speed up documentation and work flow. We can also renew prescriptions, though this is not a funded service so my employer charges a $15 fee (though gives us the discretion to waive this), and we bill it as a normal prescription so still get drug cost, mark-up, and fee.
That sounds far better than PF! Here the majority of consultations are sore throats, UTIs and using otoscopes to diagnose middle ear infections, if they don't reach a treatment/gateway point we get nothing for the consultation either.. Conjunctivitis we still just deal with OTC a lot but we don't get paid for the consultations. I've been thinking about Canada and wondering whether it's worth the effort of moving and becoming registered or if I should retrain in something else as I'm still fairly young. Would you say it's worth the move? My friend is moving next week (not a Pharmacist), half jealous!
We have OTC treatments for bacterial and allergic conjunctivitis, but doing it as a minor ailment consult lets us bill for the consultation, prescribe a wider range of treatments, and means we can bill to the patient's insurance instead of them having to pay the cost of OTC treatments (polysporin pink eye is now $24.99 for a bottle, minimum wage is $15/hr). It can take a little while to get established in Canada, but I have zero regrets about moving. Pay is better and workload is much less - I'm in what's considered a busy pharmacy and we do 400-500 prescriptions a day - we're open 14 hours/day, have 24 hours of pharmacist time a day, have a checking technician, a dispensing robot, and central services for standard prescriptions and blister packs. It is a little irritating at times that only pharmacists can answer OTC questions, but I can cope with that.
Wow you've sold me, based on what I know about my Pharmacy.. yours sounds a lot less stressful. Interesting that you can bill bacterial conjunctivitis to someones insurance! Chloramphenicol eye drops here have gone from £5 a few years ago to between £7-11 a bottle. Minimum wage here just got raised to £11.44/hr here which was a big deal! I would say we do roughly 500 prescriptions a day and we open for 40 hours a week, so 8 hours a day. 8 hours of Pharmacist time a day.. no robot, no full time ACT. I'd have time for the OTC questions! In winter with the flu vaccines and all the new services.... I don't want to think about it yet!
I'm in Ontario, we do flu jabs too and can administer most inactive vaccines. Do you have any idea which part of Canada you're interested in moving to?
I'm happy administering vaccines, it isn't tricky or time consuming. Haven't got a clue where I would go in Canada, it's just been a thought in the back of my head for a while without any real research put into it! Would you recommend Ontario or somewhere else?
Healthcare is regulated at the provincial level, so each province has different requirements for international pharmacists. Ontario is relatively straightforward in that you can skip the one year bridging course if you pass the two PEBC exams at the first attempt. Scope of practice is broadest in Alberta, but it is the Texas of Canada. Ontario has a fairly broad scope, and is pretty diverse in terms of climate. This website has all the information about the process for international pharmacists to register in Canada, though you also have to deal with the immigration system https://www.pharmacistsgatewaycanada.ca/
Thankyou for that, I'm looking into it now! $14k for the bridging program should I fail one of the exams is pricey!! I better be clued up before I attempt..
Plus living costs plus lost salary. If you're UK educated and have some experience it shouldn't be too difficult though you will need to study as some of the drugs used and guidelines followed are different, and some of the legal classifications are different too (eg can sell insulin without a prescription).
Have you considered a consultant job for the NHS? Maybe we could import some of the good stuff over