We have been thinking recently about whether it is appropriate for community pharmacist prescribers to dispense prescriptions they have written.
We question the accepted practice of UK dispensing doctors not only because of the lack of a clinical check on a patient’s prescription but also because of their financial interest in the dispensing of medicines.
We have discovered that most ofEurope has legislated to prevent doctors from dispensing medicines primarily because of the concern that they may be making a financial gain from sick patients. This first occurred back in the 13th century with the Edict of Palermo. It is a concept that has never reached our shores.
We are not for one moment suggesting that dispensing doctors are interested in making financial gain out of sick patients. However, this raises interesting questions with regard to pharmacist prescribers. If a community pharmacist who has qualified as an independent prescriber were to issue a prescription and then dispense it, would that not put pharmacists in the same place (clinically and financially speaking) as dispensing doctors? Who would clinically check the pharmacist’s prescription? What is to stop pharmacists from writing prescriptions for stock items that are about to go out of date?
There should a principled divide between prescribing and dispensing and we have always voiced our opinions to colleagues about dispensing doctors. But for this argument to hold, it needs to extend to all professionals, including pharmacists.
We do not believe we can continue to voice our concerns against dispensing doctors while pushing for independent prescribing rights for community pharmacists or any pharmacists who are involved in the dispensing of medicines.
With changes to the pharmacy contract and the way the profession operates coming in the years ahead, we believe it is important to address these issues now rather than waiting until they are exposed by, say, The Daily Mail in 20 years’ time.
Michael Twigg and Jessica di Gesso, Norwich
