Phased prescriptions

Just a quick piece of background.  When pharmacists dispense a medical card prescription in phases (usually weekly) we get paid an extra fee of €3.27 per phase.  Over the last few months the GMS have been making us jump through hoops to get this.  Despite meeting all the GMS’s self imposed requirements they currently reject payment for about 20-25% of these claims.

Today they introduced a new hoop.  I will quote from another pharmacy forum.

It gets better.
The circular says that a pharmacist can apply for phasing where they carry out an assessment of the patient’s needs and decide that, in their professional opinion, phasing is needed. This professional judgement must then wait until the next working day (i.e. 4 real days in the case of a bank holiday weekend. Days when a patient needs medication.) for the approval of a person who has never met the patient and knows nothing about them except what can be conveyed in a few sentences. If the application is rejected it can be appealed to the local HSE pharmacist who will need written evidence of the assessment which was carried out. Apparently we need to take out a sheet of paper and write down the factors that made us think a confused elderly person living alone on a pick-mix of medicines might not be able to manage. We should also write down the dates of previous occasions when they got mixed up and took too much or too little of their meds. We really have nothing else to do when we get a 10 item hospital discharge script late on a Friday evening.

Meanwhile a doctor can get automatic approval without even having to give a reason and without making any attempt to reduce or rationalise the drug regime in order to make it easier for the patient to manage. In many cases the need for phasing stems from inappropriate prescribing that we have no ability to tackle.

Perhaps they are happy for a confused patient to get a full supply of their medicines, lose them or get mixed up and then have to get duplicate supplies or perhaps for an unstable psychiatric patient to get a potentially lethal quantity of tablets.

It seems that they are doing their best to get the whole medical card system to implode.


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