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Developing voluntary delivery systems

Consider using volunteers or collection points to distribute medicines, writes Dr Jeremy Phipps.

Public reaction to the Pharmacy White Paper has demonstrated that there is considerable goodwill toward dispensing practices from their patients, and many want to help in practical ways.

Our practice has been fortunate that, for a number of years, a group of our patients has organised a rota for delivery of medicines to the housebound in one of our larger villages. This has proved very successful.

Another local practice arranges delivery of medicines from its dispensary to a local post office for collection by patients or their relatives and friends. Both systems rely on co-operation and mutual support and give widespread benefit.

Local shops such a post offices can serve as collection points for dispensed medicines as an additional service to their customers

Local voluntary delivery
Our own system is organised by our Patient Participation Group and targets elderly patients within one village. It has become an integral part of our services and so needs no publicity.

The volunteers live in the village and consequently are usually known to the patients. Medicines are collected from the dispensary three times a week on regular days.

As these patients are over 60, there is no prescription charge to pay. The scrips are computer-generated and state the date-of-birth so the reverse sides of the prescriptions do not need completion, thus making the system less onerous for the volunteers.

We do not deliver any controlled drugs by this system, but it would be possible with suitable ID checks on the volunteers.

The delivery drivers involved are acting as the patient's representative, picking up their medicine just as any friend could do. This means that there are no problems with car insurance or Criminal Records Bureau checks. These are potential problems that could otherwise discourage volunteers.

Patients are aware of the mechanics of the system and, by asking for delivery, give implied consent to the potential release of their medication to these volunteers. We have never had any problems in this area but would be greatly concerned should it ever arise.

The medicines are placed in bags and labelled with the patient's name and address. In common with many dispensing practices, we use the repeat prescription side of the prescription for this purpose.

On the rare occasions that the patient is not in, a word with a neighbour will usually clarify the situation. Only rarely do any medicines need to be returned to the surgery.

Local collection points
Some rural surgeries offer delivery to a central collection point from which patients are able to collect their dispensed medicines. Village shops and post offices are ideal as the owners will often be willing to accommodate this extra service for the increase in business it may generate.

The Dispensing Doctors' Association (DDA) gives guidance in its booklet Quality in Practice, last published 2006, on the standards to be expected for this service. These are not enforceable but, as with all guidelines they are an aid and are helpful if any problems arise.

Pharmacists work under a more tightly regulated system and are unable to use a central distribution point that is not a pharmacy.

The DDA recommends the use of a responsible person for onward distribution to customers. The medicines should be in individual bags - sealed with tape or staples with the name and address of the patient clearly labelled on the outside - and delivered to the distribution point in a locked box in case of an accident.

Most schemes I am aware of deem a locked car boot to be sufficient.

It is recommended that a collection book is sent with the medicines. This can be completed by the responsible person or their deputy to record the medicine has been collected, by whom and when.

The guidelines do, however, recognise that this may not always be possible if the shopkeeper feels this is too onerous and consequently it may be waived.

To ease administration and help security, it would be best to ensure that only fee-exempt prescriptions are sent and no controlled drugs.

The use of willing volunteers can be very successful in supporting practices and their patients and is one of the rewards of rural practice. It is unlikely a commercial pharmacy could mobilise such resources.

Dr Phipps is a dispensing GP in Lincolnshire

Delivering Medicines to Patients
Voluntary delivery

  • Volunteers act directly on patient's behalf.
  • Volunteers have regular delivery sessions.
  • Medicines must be clearly labelled with name and address and be placed in a sealed bag.
  • A system must be developed for controlled drugs.
  • Administration should be kept to a minimum.

Local collection point

  • Practices liaise with local businesses, post offices are ideal.
  • Practices arrange transport to collection point.
  • Medicines are placed in sealed, labelled bags.
  • Ideally, a register of when medicine is collected, and by whom, should be compiled.
  • DDA guidelines should be followed.

The DDA

The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit www.dispensingdoctor.org
The DDA does not necessarily support or endorse the opinions or information contained on this page.

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