Pharmacists administering vaccines

sam34 · 23-09-2011 06:02AM

ffs lads. let's get back on topic and leave out the pettiness.

angeldelight · 23-09-2011 11:33AM

To start with, just want to declare I have a vested interest in the topic as I'm a pharmacist.

I think it's a great idea, for pharmacists and patients alike. For us it's great to be given extended roles and to have the government recognise our position as healthcare providers rather than shopkeepers. For the public there are also benefits - pharmacies have longer opening hours than doctors surgeries so it should be more convenient for people and they hopefully won't have to wait as long to be seen as if they went to their GP.

It's working successfully in other countries so I don't see why it won't be a success here. I myself won't be taking part, (due to an extreme squeamishness and fear of needles!), but I will be getting my flu shot from a pharmacist, as I'm fully confident that they can do the job

smtdos · 23-09-2011 03:38PM

If it does come in, pharmacist will have to come across extremely professional.

I wonder about the standard of consultation areas. Patients will and probably should expect close to a private room when getting a jab.

feels2gd2btrue · 23-09-2011 05:21PM

smtdos wrote: »

If it does come in, pharmacist will have to come across extremely professional.

I wonder about the standard of consultation areas. Patients will and probably should expect close to a private room when getting a jab.

Pharmacies are required by law to have a consultation room so that won't be a problem regarding privacy for patients.

smtdos · 23-09-2011 05:23PM

feels2gd2btrue wrote: »

Pharmacies are required by law to have a consultation room so that won't be a problem regarding privacy for patients.

That's my point. It was a requirement to have one fitted to all pharmacies but some I've seen are far from suitable!

To be fair it's v difficult to add such an area to an existing pharmacy where space is at a premium as it is.

23-09-2011 05:25PM

I have no problem with it at all, pharmacists will be well capable of doing this. As angeldelight said, it's more convenient for certain groups of people, such as those with busy schedules/working hours that could find it difficult to fit in an appointment during their GP's working hours, not to mention the cost aspect too. There are people who probably won't change - some of the over 70s or others with medical cards who regularly attend their GP and are used to getting bloods/injections/consultations on a regular basis will probably continue to get it there rather than at the pharmacy.

It will be interesting to see how the figures stack up when this season's campaign ends - for those availing of it through their GP -vs- pharmacy, and the demographics of same.

foreverandever · 23-09-2011 05:45PM

I think the reason GPs are protesting is not because they don't trust pharmacists but they're worried about monitoring the high risk patients who are to receive the vaccine and keeping a record of who else received it and then entering it on their medical record. I don't think the pharmacists have come up with any solution for this yet that wouldn't involve more work than just the patient receiving it in their GP surgery?

bleg · 23-09-2011 06:03PM

foreverandever wrote: »

I think the reason GPs are protesting is not because they don't trust pharmacists but they're worried about monitoring the high risk patients who are to receive the vaccine and keeping a record of who else received it and then entering it on their medical record. I don't think the pharmacists have come up with any solution for this yet that wouldn't involve more work than just the patient receiving it in their GP surgery?

No. These are the reasons that GP give to veil the real reason: they don't want to lose revenue!

Dr Galen · 23-09-2011 06:04PM

That likely works both ways in fairness Bleg

foreverandever · 23-09-2011 06:07PM

Why lose revenue and add extra work?

smtdos · 23-09-2011 06:18PM

Revenue is going to be lost one way or another either to pharmacists or fempi

bleg · 23-09-2011 06:22PM

Dr Galen wrote: »

That likely works both ways in fairness Bleg

Agreed but lets stop hiding behind different issues.

foreverandever · 23-09-2011 06:39PM

Where's the incentive for doctors to stop administering the vaccine? Yes money is an issue, general practice is a business, but also the extra work that would come with the pharmacists administering it. Why would they change a system that is working?

jimdeans · 23-09-2011 06:56PM

bleg wrote: »

No. These are the reasons that GP give to veil the real reason: they don't want to lose revenue!

Massive generalisation to say that the only reason GPs might question this is because of revenue.

It would be as easy to take the line from a pharmacist above who said "it's great because the govt are looking at us as professionals rather than shopkeepers" and say that he or she is lying.

I know a good few GPs who really care about their patients. No-one has said anything about it to me. But pharmacists don't have training in practical procedures, so they're right to ask the questions. I don't object to it, but I'm glad the GPs are asking the questions.

I've had anaphylaxis (to codeine...apparently dead rare!). I was in a hospital lab at the time, so went upstairs to A+E and I got a drip straight away with a steroid and adrenaline into my arm. Can the pharmacist do that, like the GP could? I don't know the answer (and I know a pharmacist can call an ambulance). But I'm sure someone said above that pharmacists will be trained to deal with allergic reactions. Can they put in drips? Again, i don't know the answer, but I'm glad someone is asking!

christmas2010 · 23-09-2011 07:56PM

On the subject of cost I was in the UK last week and Boots were advertising the flu vaccine for £7.50.
Last winter my GP was charging €40, so a bit of healthy competition might not be a bad idea.

bleg · 23-09-2011 08:24PM

jimdeans wrote: »

Massive generalisation to say that the only reason GPs might question this is because of revenue.

It would be as easy to take the line from a pharmacist above who said "it's great because the govt are looking at us as professionals rather than shopkeepers" and say that he or she is lying.

I know a good few GPs who really care about their patients. No-one has said anything about it to me. But pharmacists don't have training in practical procedures, so they're right to ask the questions. I don't object to it, but I'm glad the GPs are asking the questions.

I've had anaphylaxis (to codeine...apparently dead rare!). I was in a hospital lab at the time, so went upstairs to A+E and I got a drip straight away with a steroid and adrenaline into my arm. Can the pharmacist do that, like the GP could? I don't know the answer (and I know a pharmacist can call an ambulance). But I'm sure someone said above that pharmacists will be trained to deal with allergic reactions. Can they put in drips? Again, i don't know the answer, but I'm glad someone is asking!

It works fine in boots in Ireland and in pharmacies in general in other countries.

Sid_Justice · 23-09-2011 10:59PM

You can flip that around and point out that nurses don't have anything close to the pharmacological knowledge that pharmacists have.

Sid_Justice wrote: »

exactly that's why nurses generally don't dispense drugs, prescribe or give pharmacological advice to doctors.

Opinion_guy don't make any asumptions on what I meant to say or didn't say. If i meant administer I'd have said administer. If people had any sense here and wanted 'context' on my post, they would have seen it wasn't a slur on nurses but an example of why pharmacists have job that makes them a pharmacist and nurses have a job that makes them a nurse. Pharmacists should avoid doing nurses' jobs because they're not qualified/trained to do them and nurses should avoid doing pharmacists' job. Pharmacists aren't qualified or trained to administer drugs, nurses are. the hse wants to spend thousands training pharmacists to do the job nurses already are able to do.

Let boots employ a nurse to administer vaccines in pharmacies if the public would like to avail of such facilities. Howver I know I'd wouldn't want to be in some converted cupboard in boots if I had a unusual reaction to a flu jab.

foreverandever · 24-09-2011 08:50AM

christmas2010 wrote: »

On the subject of cost I was in the UK last week and Boots were advertising the flu vaccine for £7.50.
Last winter my GP was charging €40, so a bit of healthy competition might not be a bad idea.

The UK and Irish Health systems are completely different!

Milltrix · 24-09-2011 10:10AM

Indeed you could probably train a monkey to give a shot but there's a bit more than that; making clinical decisons about who should have any particular vaccine, the contraindications / risks associated for people with certain medical conditions etc.

bleg · 24-09-2011 12:23PM

Milltrix wrote: »

Indeed you could probably train a monkey to give a shot but there's a bit more than that; making clinical decisons about who should have any particular vaccine, the contraindications / risks associated for people with certain medical conditions etc.

Seriously, why can't people on here get the point? Pharmacists are already administering vaccines in Ireland with no major problems as far as I'm aware.

It happens in other jurisdictions also without any major problems as far as I'm aware.

Why the sudden outrage over patient safety now?

Irish pharmacists are already administering the vaccine.

The fee has been set at 15 euro.

opinion guy · 24-09-2011 12:26PM

Milltrix wrote: »

Indeed you could probably train a monkey to give a shot but there's a bit more than that; making clinical decisons about who should have any particular vaccine, the contraindications / risks associated for people with certain medical conditions etc.

Pharmacists know FAR more about the contraindications/risks of medicines than doctors or nurses do

foreverandever · 24-09-2011 12:51PM

bleg wrote: »

Seriously, why can't people on here get the point? Pharmacists are already administering vaccines in Ireland with no major problems as far as I'm aware.

It happens in other jurisdictions also without any major problems as far as I'm aware.

Why the sudden outrage over patient safety now?

Irish pharmacists are already administering the vaccine.

The fee has been set at 15 euro.

because who is monitoring to make sure all the high risk patients are receiving their vaccines and are the pharmacists ensuring that doctors are aware of which of their patients have already received the vaccine.

smtdos · 24-09-2011 12:55PM

foreverandever wrote: »

because who is monitoring to make sure all the high risk patients are receiving their vaccines and are the pharmacists ensuring that doctors are aware of which of their patients have already received the vaccine.

I think the idea is that ultimately doctors and pharmacists will use the same PCRS interface to log vaccinated patients. That way, both parties can see if someone has had the jab already.

foreverandever · 24-09-2011 01:06PM

smtdos wrote: »

I think the idea is that ultimately doctors and pharmacists will use the same PCRS interface to log vaccinated patients. That way, both parties can see if someone has had the jab already.

that is probably ultimately the perfect solution but seeing as it's not even close to being put in place who should have the responsibility to ensure that patients are receiving the vaccine? I'm thinking of a scenario where a patient goes to the pharmacist and is filling a prescription and the pharmacist tells them about the new vaccination system, patient decides he'll get it there the next time. The doctor/nurse rings a few weeks later reminding the patient about the vaccine, patient informs them he's going to get it in the pharmacist. However last time he was was in the pharmacist he filled a 3/6 month script so has no reason to return at the moment and forgets to go back. Who should be following up this patient to ensure he receives the vaccine and who is at fault if he doesn't get it?

smtdos · 24-09-2011 01:23PM

foreverandever wrote: »

smtdos wrote: »

I think the idea is that ultimately doctors and pharmacists will use the same PCRS interface to log vaccinated patients. That way, both parties can see if someone has had the jab already.

that is probably ultimately the perfect solution but seeing as it's not even close to being put in place who should have the responsibility to ensure that patients are receiving the vaccine? I'm thinking of a scenario where a patient goes to the pharmacist and is filling a prescription and the pharmacist tells them about the new vaccination system, patient decides he'll get it there the next time. The doctor/nurse rings a few weeks later reminding the patient about the vaccine, patient informs them he's going to get it in the pharmacist. However last time he was was in the pharmacist he filled a 3/6 month script so has no reason to return at the moment and forgets to go back. Who should be following up this patient to ensure he receives the vaccine and who is at fault if he doesn't get it?

Firstly, pharmacists see patients more regularly than gps so I don't see your point on that.

In general, patients have to come to the pharmacy every month to collect their tablets, they only have to see a go every 6. Surely then a pharmacist is better placed to remind patients about vaccines?

Plus pharmacists are just as capable as a gp's secretary of picking up the phone to ring a patient.

But your missing the bigger point: this is simply a flu vaccine service. It's seasonal. Pharmacists will see patients at least three times during the winter, a gp maybe not at all. As bleg said, it's working perfectly elsewhere. It's not like pharmacists are giving hep injections and need ppl to come back for booster doses.

foreverandever · 24-09-2011 01:45PM

smtdos wrote: »

Firstly, pharmacists see patients more regularly than gps so I don't see your point on that.

In general, patients have to come to the pharmacy every month to collect their tablets, they only have to see a go every 6. Surely then a pharmacist is better placed to remind patients about vaccines?

Plus pharmacists are just as capable as a gp's secretary of picking up the phone to ring a patient.

But your missing the bigger point: this is simply a flu vaccine service. It's seasonal. Pharmacists will see patients at least three times during the winter, a gp maybe not at all. As bleg said, it's working perfectly elsewhere. It's not like pharmacists are giving hep injections and need ppl to come back for booster doses.

if you think of asthmatics, alot of them wouldn't have to go to their pharmacist to pick up inhalers every month yet they're recommended to get the vaccine. Also pharmacists just took it upon themselves without any consideration to how patients would be affected by this. Why didn't they sit down with the doctors and make a plan for the winter coming to ensure people don't slip through the cracks. Doctors have lists of patients who are at risk and who need the vaccine, all of whom go to different pharmacies.

jimdeans · 24-09-2011 01:54PM

bleg wrote: »

Seriously, why can't people on here get the point? Pharmacists are already administering vaccines in Ireland with no major problems as far as I'm aware.

It happens in other jurisdictions also without any major problems as far as I'm aware.

Why the sudden outrage over patient safety now?

Irish pharmacists are already administering the vaccine.

The fee has been set at 15 euro.

Why can't pharmacists understand that it's not "outrage over patient safety". It's people asking questions. I'm a virologist, so I could say I know shedloads about flu and therefore I can administer the vaccine.

But I'd expect to be asked some VERY searching questions if I annonced plans to do so.

jimdeans · 24-09-2011 02:00PM

opinion guy wrote: »

Pharmacists know FAR more about the contraindications/risks of medicines than doctors or nurses do

It's all about context, though. I know a load more about the theory of various viruses than me missus. But she's a doctor and is better at treating people with those viruses than I would be.

It's not about knowing the interactions alone. It's about deciding who has one of those contra-indications (maybe that requires clinical acumen), or who develops a side effect (how quickly the person can work out "oh oh this is anaphylaxis....mine reaction started with a weird pins and needles type thing, but the doc knew immediately what it was and i was treated just in time just my breathing was starting to become a bit affected) and how that should be dealt with (can the pharmacist treat these allergies?).

All people like me can do is put ourselves int he position of someone who has a bad reaction, and ask ourselves would our local pharmacist be able to handle it. My local pharmacist is a good guy and very friendly. But he's about 60 and won't have touched a patient before, so I wouldn't be going to him for my vaccine.

angeldelight · 24-09-2011 04:37PM

bleg wrote: »

The fee has been set at 15 euro.

Just to point out that 15 euro has been proposed by the HSE as what they are proposing to pay pharmacists for vaccinating medical card patients.

Different pharmacies will set their own prices for charging private patients.

Pharmacists have been trained to deal with anaphylaxis, should it occur, and call for an amublance for further care for the person.

jimdeans · 24-09-2011 04:56PM

angeldelight wrote: »

Pharmacists have been trained to deal with anaphylaxis, should it occur, and call for an amublance for further care for the person.

What do you mean deal with? What have you been trained to do to a patient who has an anaphylactic reaction?

Pharmacists administering vaccines

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