
Laura Buckley
If you work in community pharmacy, you’ll be familiar with the patient returns situation. If not, you need to know what is going on.
It needs to stop.
When a community pharmacy hands out medicines on an NHS prescription, the prescription is retained until the end of the month and then it is sent to the NHS pricing department who then arrange payment to the pharmacy for the item, and a small fee for the work involved in dispensing it. The money for the medicines you get on your prescription comes directly from the NHS to the pharmacy.
In our pharmacy, when we hand out medicines, we ask what is needed for next time. Our patients are privileged that we can still reorder their medication for them for the following month. But we ask what you need and don’t presume because we don’t want to create a build-up of excess medication in the cupboard. We know that people order things just in case they run out and even some say ‘for a rainy day’, but often medicines or doses change and all the excess serves to do is to gather dust and occupy unnecessary space.
When patients have sadly passed away, we often get bin bags full of medicines brought back to us. These medicines can be worth hundreds of pounds! The hoarding of medicines is a humongous problem that doesn’t seem to be getting any better. You see, once a medicine leaves the pharmacy, it cannot be returned to the dispensary shelves to be reused for somebody else. We do not know if it has been stored in extreme temperatures which can affect the quality of the medicine. We do not know if it has been tampered with or if falsified medicines have been maliciously reinserted into the boxes. Because we cannot guarantee the safety, efficacy and integrity of the medicines then they all go in the bin.
Every single tablet.
Every single patch.
Every single tube of cream.
Every single inhaler.
Every returned medicine brought back to pharmacy.
All binned.
The harsh reality is that some of our patients now are struggling to get hold of certain medicines because they are out of stock and we are still seeing these items that they need returned and throwing them away. Some patients are struggling where others have hoarded medication. Some blame pharmacies, claiming we order medicines unnecessarily. We request prescriptions for what you want us to provide. There is no pharmacy crystal ball and there is no direct CCTV link to your kitchen cupboard. NO, we do not know what you have at home unless you tell us and we do not know if you have stopped a medicine unless you tell us. If you forget and it ends up in the bag ready to hand out to you but you don’t need it, take it out at the point of collection if necessary and we can return it to the shelf and cross it off of the prescription.
Regardless of whether you pay for your medicines or you get them free, it is NOT your right to take from the system what you don’t need. It is NOT your right to stockpile medicines so that others lose out and the NHS loses money. Take responsibility for your medicines and come into pharmacy knowing what you need; count your tablets if needed and write them down so we can help you.
The patient returns that include countless boxes of the same medicines break our hearts. The work we put into dispensing them wasted, the frustration with medicines shortages amplified and the sheer cost to the NHS, well that’s just shocking. Here in the UK, we are so very proud of our NHS and so very reliant on it in our time of need. Right now, the NHS needs you. It needs you to stop wasting medicines that you don’t need. It needs you to use the services your pharmacy provides wisely.
Laura Buckley is a pharmacist with experience in community pharmacy and now works in general practice.
The waste in our NHS is disgraceful and I deplore the squandering of this precious resource. However this is not just the fault of the patient and we all need to take responsibility for not reviewing medication, ensuring patient can use medication and also (some pharmacies) automatically reordering repeat medication.
Patient adherence to medication is also a complex issue with multiple beliefs and behaviours linked to needs and concerns about medicines, understanding of medical conditions and how medication works amongst other issues.
If we can all work together – patients, GPs, pharmacists, nurses, reception staff, pharmacist technicians, and counter staff in community pharmacies we might stand a chance of reducing waste….
Please don’t lay all the blame on the patient.