NHS Prescriptions and Pharmacies

Lloyds Direct for me - dead easy and delivered to my workplace.

Don't know about other places, but the pharmacy/ist in the village near me (Scotland) is ace and seems quite busy; seems a large amount of dispensing to elderly on repeat prescriptions in the area.

He's also good at offering things on prescription instead of me buying when I've gone for a wide range of things I expected to pay for. Free prescriptions in Scotland are a godsend to me and many others. I remember back when I lived in England needing repeat prescriptions it cost me a fortune that I often struggled to pay.

Yep like social care, nursery places, NHS dentristry, care homes the government claims to provide free services but under pays the private providers and wonders why they close down. My brother works in the industry, distribution to the pharmacies rather than retail, the i dustry has been on its arse for awhile. Im lucky our local Boots is undergoing a refurb so likely to stay open. They are very good, way better than the pharmacy attached to our surgery.

Little independent one near me does free delivery if required, I pick up and it’s always busy. Boots in town is absolutely shocking, rarely open and has very few staff on.

If you were happy with your current pharmacy you could shift to their online delivery service.

https://www.boots.com/prescription-support/prescription-delivery-service

There’s clearly a desperate shortage of pharmacists. 

Actually no, there's probs too many if anything. Effect is the same though, some have left, most have been employed by local GP networks to retrain as clinical pharmacists (as opposed to dispensing) because high street shopping is dying on its arse. and it effects chemists just as much as any other business. Unless you chose a pharmacy that's near to your GP practice, they're getting shut down just as fast as pubs and newsagants My advice is if you have regular 'scripts, get them delivered. 

we've got a local dispensing chemist that's open from 8.0 am every day including sundays (bloody godsend when your running 40 with UTI).

Yes same issues here in the highlands regarding that national chain which is made for walking. Getting the meds delivered isn't an option for me as I work shifts

If you were happy with your current pharmacy you could shift to their online delivery service.

I actually previously paid Boots for delivery, and they quietly and without warning stopped delivering after 10 months because of apparent understaffing in the large branch responsible for packing and delivering. I twice queued over 60 minutes to collect those prescriptions, and with no effective means to pursue whoever in the corporate structures was responsible decided my only feeble recourse was to boycott Newmarket Road Boots Cambridge and curse them to the sea at every opportunity. Utter charlatans.

a small suburban branch of a footwear-themed high street cosmetics and sandwich retailer

Boots have been culling branches but they did seem to have a weird over-supply of them in places - Killie has five of them which if they were spread around the various communities if the town would be fine- but theyre all less than 100m from each other.

One thing that undermines the viability of a lot of pharmacies is supermarkets who lobbied for the removal of 'Retail Price Maintence' back in 2001 - an arrangement for non prescription medicine sales that kept prices at a level that made Pharmacy shops viable. In effect supermarkets stripped away all the sales other than prescribed medicine. This was of course sold as win for consumers was being able to buy packs of paracetamol for 16p (that comes with just the minor headache of real medicine not being readily available when you need it)

The one attached to my GP practice is great, and open late and at weekends too. They're a stark contrast with the GP practice who are both abysmal and rarely available.

I remember back when I lived in England needing repeat prescriptions it cost me a fortune that I often struggled to pay

I'm unfortunately on 9 prescription medications at the moment which would be just about manageable with the season ticket but if I had to pay individually - oh boy! Luckily I'm old enough to get them "free".

Hi, community pharmacist here. There are so many issues facing us at the moment, it's hard to know where to begin.

A few years back, the Dept of Health announced, quite openly, that they intended to cull about 3000 pharmacies from the numbers as they felt there were too many too close together, in too many places. Rather than identify those locations and maybe pay some to shut down, they decided to start paying us less and less until "enough" closed down with the (obvious) effect the first to go are those in marginal areas where numbers are low, but the service is the only one available for miles around.

The basic payments have been frozen overall by the government for several years now. Every time minimum wage goes up, it's coming off the bottom line with no ifs or buts. Don't mention rising fuel bills etc. Guess why everywhere is understaffed now?

Talking of payments, the government did finally admit 15+ years ago that our good buying skills on drugs against the list prices, leading to profit for pharmacies, had been effectively funding the system forever. They tightened up on that a bit, while deliberately over-paying on some common generic lines to allow us to retain some of that profit (without them having to be seen to pay us a realistic headline figure). Local Health Boards (or whatever you have your way) spotted this, and started telling GPs to prescribe brands in those cases, which were far more expensive than the actual generic price, but still cheaper than the price we would be paid for the generic... money we are supposed to be getting to fund the service but are being denied in favour of making the HB's costs look better.

Then you've got manufacturers changing from regular wholesale dealing to agency models limiting both availability and available discount. Brexit hasn't has as much to do with it as some are shouting IMO, but the weak pound means importing medicines from the EU is less profitable than it used to be, even before the extra hassle.

Just in time manufacturing also means constant stock issues and the agency models means there's no slack in the system at wholesale level - for a lot of products if the place you get them goes out of stock, that's it, there is simply none anywhere else. We send a good chunk of time every day trying to source an ever-changing list of 50-60 lines that are out of stock... talking to wholesalers, manufacturers, other pharmacies, surgeries and of course upset patients. Oh, and when that saving-the-Health-Board-money branded product goes OOS, we have to spend time chasing the generic alternative with the surgery... which they really should have been prescribing in the first place.

In the meantime the government is giving GPs extra money to recruit other healthcare professionals into surgeries and this is proving a big drain on the available pool of community pharmacists. Whether they'll keep them on once that money dries up remains to be seen...

And script numbers are constantly rising - I saw a comment maybe 10 years ago that "the average pharmacy now requires an extraordinary pharmacist" to run it, and things have only gone one way since then. The GPs are feed up with this, too - they see signing repeat scripts as an unwelcome part of their workload and will often put it off; locum doctors frequently refuse to do it at all. Which means our work comes through either late in the day (which is poor/hopeless from a workflow PoV for us), or in two-day's-work together megapiles (again, late in the day) which customers then expect us to process within minutes.

And finally for this rant/info dump, here in Wales we have had the Common Ailments Scheme for a few years now, England are about to launch Pharmacy First which seems quite similar. And in Wales, we are all being encouraged (by the heavy redirecting of our payments) to become Independent Prescribers as well, with the ability to treat more people for more conditions. As you might guess, the difficulty arranging an appointment with a GP means these are very popular services - we have gone to appointments as well, but it is not something that's really sustainable unless you have 2 pharmacists in the shop as it rapidly becomes 2 full-time professional jobs you are being expected to achieve with one pair of hands.

It's no wonder pharmacists are leaving community as fast as they can; I've not even touched on the abuse we get from some customers or how hard it is to retain half-decent staff when they can literally get paid more to stack shelves in a supermarket.  The whole system is teetering on the brink. LloydsPharmacy have just left the market, selling off or closing every single branch. That may be down to pure asset-stripping private finance, but it's a worrying sign - pharmacy even 10 years ago was seen as a solid gold reliable investment.

Maybe 5 years ago, I would have said that I could foresee Amazon (or whoever) taking over a big chunk of regular repeat dispensing at some fairly distant point in the future; frankly now it can't happen soon enough. But we won't be able to pick up the pieces when Evri fall apart again at Christmas.

Lloyds Direct for me – dead easy and delivered to my workplace

which is precisely the problem. Don’t you see that?

Thanks for the insight there defblade.

There are little bits of info there that mirror exactly what I've heard from my local pharmacist.

On a side note, the abuse they get is awful. A few months back a guy was threatening to wait outside for the female pharmacist to "**** her up."

Did Boots not get taken over by some rather unsavoury folk recently?

Walgreens from the US bought them back in 2014. They tried to offload Boots last year but never got a buyer. The talk is they will try and offload them again soon to focus on the US. They just sold the pension liability to Legal +General last week and plan to close 300 stores etc to make a sale more tempting to buyers when it does go back on the market.

I can recommend Pharmacy2U

https://www.pharmacy2u.co.uk/