Cost cutting = Care cutting?

The NHS is facing huge pressures, the NHS has no money, the NHS must cut wastage and optimise budgets. We all know this and I am sure many pharmacists have noticed the prescription clerks at the GP surgeries clamping down on repeat medication. How many times do we have to pass on messages: "Your prescription is not due" "You are over-using this item".

Surprisingly this is not a rant about us taking the flack for decisions made by the surgeries. This instead a reflection upon a now regular incident...

I have one nearby surgery that thinks it is appropriate to stop Warfarin repeats "due to overuse - please hand in your yellow book" without informing patients. How overuse can be established without seeing said INR book is beyond me. This has led to many, many concerned patients and phone calls to the doctor to get a prescription through. Unsurprisingly, the GP will not let a patient go without warfarin and produces a prescription, which then requires complications trying to get said prescription, on a Friday afternoon, when the surgery won't fax and the driver is out 20 miles away and the patient can't drive.

Therefore the thought of the day is simple, yes make savings but think of the impact on the patients first and NEVER use a one-policy fits all attitude. The patient may be using more than you would expect, but is this understandable? Perhaps if we all had more impact in these sorts of decisions then a more individualised approach would be taken.

I read Connie Pringle's blog (http://www.pjonline.com/blog_entry/pharmacists_sto...) which mentions the "radical suggestion [of] an 'in-house' pharmacist in every GP practice". I say, we need it now. Prescription clerks have little to no medical training, so how can they be expected to make clinical decisions.

We have, can and should.