Patient choice is a central tenet of the NHS, yet the Regulations, as they stand, confound this principle.
Over the past century, the rules governing patient eligibility for dispensing services have changed very little since 1911. However, during the past 100 years medicine and technology have come a long way, and the boundaries between pharmacy and medicine have become less rigid; not only do doctors dispense, but increasingly, pharmacists prescribe. Current NHS Pharmaceutical Services Regulations, which govern the provision of dispensing by doctors, make few allowances for these changing boundaries.
In fact, in Scotland, services provided by dispensing doctors are not considered pharmaceutical services. A dispensing doctor is defined as a contractor who is required by the NHS Board to provide dispensing services where no pharmaceutical services exist.
The DDA believes that the Scottish regulations prejudice dispensing services provided by practices, due to the Regulations’ definition of pharmaceutical services, the lack of meaningful consultation with patients, and the lack of acceptance by Government of the need for cross subsidy.
Since introduction, the regulations have led to several contentious pharmacy openings, and for the affected practice, the subsequent total loss of dispensing rights.
A DDA survey reveals that 89% of patients who are not eligible to receive dispensing doctor services would like to have the option to do so.
Rural patients report high satisfaction with their rural practice and do not want to see the service change. Many dispensing practices have patients who have been registered with the practice for over 30 years; patients’ desire to remain with their rural GP practice was highlighted recently in the 2012 annual NHS in England.