Discussion
Simon Brooks said:
Slightly off track, but relevent to topic
Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
they arent allowed to. there are specific rules that govern who can and cant be a dispensing practice. one of the rules as example is that you have to have at least 1 patient that lives more than X distance from a dispensary Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
Plus the surgery also then have to employ a pharmacist, hold the stock, have a strong room, different insurances, etc... it can be lucrative but if you met the criteria, but most do not unless in seriously rural areas.
petethechemist said:
rossub said:
petethechemist said:
rossub said:
Pharmacists are private contractors. They are paid a fee to dispense - that's where the cost comes from.
But as I said, the fee for a single prescription item is £1.27, no idea where the £10 comes from!
I will bow to your first hand knowledge of the costsIt's not coming from the GP either. As far as I'm aware they are paid according to the number of patients they have, with other payments for things such as level of deprivation in the area and certain illnesses patients have to cover the greater workload. They're certainly not paid by prescription written or by appointment - that would open the door to even more vast amounts of waste!
It's more I still remember how to google the right figures!I think you're dead right on the GP funding, it relates to size of patient list, demographics of the area etc, Then if you take that figure and divide by the number of consultations they do, you get to the £30 per consultation - so it's what it costs, not what they charge/claim for it.
Plus General Practices also recieve a slew of other funding for various additional services, network arrangements, CCG participation, professional development, GPwSI elements, etc....
Simon Brooks said:
Slightly off track, but relevent to topic
Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
I'll have a crack at answering!Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
Are pharmacies viable - Yes, far less than they were in the 90's/00's but they do make money, both from dispensing prescriptions, doing NHS and private services and selling 'stuff' from the shop area. The very basic balance on NHS prescriptions (aside from the fees) is if you can buy the drug for less than the NHS reimburse you for it then you keep the profit - except the NHS are wise to this and claw back a chunk of profit at the end of the month.
The more pharmacies you own, the better deal you can get on the drugs, the more profit. So if you are a Drs surgery with a single pharmacy that puts you in the worst position to buy drugs, you also need to pay for a Pharmacist and other staff, run the shop etc. - I just don't think the hassle is worth the return - especially as I doubt a pharmacy in a surgery would take the same sort of 'retail' sales through a shop area as a high-street store would. Same answer goes for why the NHS don't run pharmacies them selves generally, too much hassle when the pharmacy companies are willing to do it - look at many hospital outpatient pharmacies - outsourced to Boots, LloydsPharmacy etc who charge a fee to run them on the hospital's behalf.
Even the big chains are cutting stores/staffing hours as the margin is thin (and getting thinner) even with 1000+ shops, massive marketing clout etc.
My bet is most of the volume of repeat prescription will be going through the online pharmacies (Pharmacy2U, ECHO etc) in the next few years as pharmacy follows the Amazon route online - can't see many Drs wanting to try and complete there!
petethechemist said:
Simon Brooks said:
Slightly off track, but relevent to topic
Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
I'll have a crack at answering!Question to someone better placed than I to explain why if owning a dispensing chemist is a viable business propostion, why dont more Dr's surgeries have thier own (to retain profit) or why NHS doesnt open dispensing chemists again to feed profits back into the system ?
Are pharmacies viable - Yes, far less than they were in the 90's/00's but they do make money, both from dispensing prescriptions, doing NHS and private services and selling 'stuff' from the shop area. The very basic balance on NHS prescriptions (aside from the fees) is if you can buy the drug for less than the NHS reimburse you for it then you keep the profit - except the NHS are wise to this and claw back a chunk of profit at the end of the month.
The more pharmacies you own, the better deal you can get on the drugs, the more profit. So if you are a Drs surgery with a single pharmacy that puts you in the worst position to buy drugs, you also need to pay for a Pharmacist and other staff, run the shop etc. - I just don't think the hassle is worth the return - especially as I doubt a pharmacy in a surgery would take the same sort of 'retail' sales through a shop area as a high-street store would. Same answer goes for why the NHS don't run pharmacies them selves generally, too much hassle when the pharmacy companies are willing to do it - look at many hospital outpatient pharmacies - outsourced to Boots, LloydsPharmacy etc who charge a fee to run them on the hospital's behalf.
Even the big chains are cutting stores/staffing hours as the margin is thin (and getting thinner) even with 1000+ shops, massive marketing clout etc.
My bet is most of the volume of repeat prescription will be going through the online pharmacies (Pharmacy2U, ECHO etc) in the next few years as pharmacy follows the Amazon route online - can't see many Drs wanting to try and complete there!
rossub said:
Monkeylegend said:
I get a free prescription of Aspirin every month.
Buy your own you tight b
dIt's £9 a month I can spend on something else.
Never look a gift horse in the mouth
The waste in the NHS is epic .
All the farming out of services doesn't make for very good reading when the true costs are discovered.
As most who have had dealings with the NHS will agree , the front line staff are on the most part absolutely fabulous. The admin and managment are very very wasteful .
My area trust have monthly board meetings ,these rotate throughout the larger hospitals within the county .
So thats multiple meeting rooms having to be furnished , prepared ,maintained and staffed along with all the movement of the paperwork and equipment . The board will no doubt all claim expenses. The board all are well paid for the position but most have multiple executive positions . The way new premises are paid for is costing the NHS billions over and above the cost of building them .
All the farming out of services doesn't make for very good reading when the true costs are discovered.
As most who have had dealings with the NHS will agree , the front line staff are on the most part absolutely fabulous. The admin and managment are very very wasteful .
My area trust have monthly board meetings ,these rotate throughout the larger hospitals within the county .
So thats multiple meeting rooms having to be furnished , prepared ,maintained and staffed along with all the movement of the paperwork and equipment . The board will no doubt all claim expenses. The board all are well paid for the position but most have multiple executive positions . The way new premises are paid for is costing the NHS billions over and above the cost of building them .
We've priced maintenance contracts for the NHS before, generally the contracts aren't cheap as there's loads of kit that breaks all the time just to sheer usage etc.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.
theguvernor15 said:
We've priced maintenance contracts for the NHS before, generally the contracts aren't cheap as there's loads of kit that breaks all the time just to sheer usage etc.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.
Something came up locally about replacing bulbs in one of the local hospitals , part of a maintenance contract and the costs were horrendous, the trust were being charged 5X the price at a local suppliers plus a labour fee for fitting .So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.
It worked out costing the trust £000s per day to have bulbs changed . Something that an in house maintenance team could have done for pennies under the old systems .
grumpy52 said:
Something came up locally about replacing bulbs in one of the local hospitals , part of a maintenance contract and the costs were horrendous, the trust were being charged 5X the price at a local suppliers plus a labour fee for fitting .
It worked out costing the trust £000s per day to have bulbs changed . Something that an in house maintenance team could have done for pennies under the old systems .
Same a mod.It worked out costing the trust £000s per day to have bulbs changed . Something that an in house maintenance team could have done for pennies under the old systems .
£10 possibiy comes from an average earning from all prescriptions. Boots was averaging £11 now I believe its £9.
Wales was prescribing way more paracetamol per head than other parts of the uk. Believe it or not you could get sunscreen on prescription in wales until recently.
Gluten free was also another issue. £30/month allowance people would order in £30 worth and then not bother collecting. Think it's been scrapped now.
One of the big issues is customer wastage, diabetics are pretty bad for this. We used to send cages of returns back of mixed drugs. We used to get customer's bringing their recently deceased relatives leftovers back thinking they could be reissued. Literally carrier bags full of unused drugs that have to be destroyed.
An over the counter authorisation slip could be implemented. Hand to cashier and a box is pulled from behind the counter no dispensing cost occurred. Many items could be moved to a [P] line.
Wales was prescribing way more paracetamol per head than other parts of the uk. Believe it or not you could get sunscreen on prescription in wales until recently.
Gluten free was also another issue. £30/month allowance people would order in £30 worth and then not bother collecting. Think it's been scrapped now.
One of the big issues is customer wastage, diabetics are pretty bad for this. We used to send cages of returns back of mixed drugs. We used to get customer's bringing their recently deceased relatives leftovers back thinking they could be reissued. Literally carrier bags full of unused drugs that have to be destroyed.
An over the counter authorisation slip could be implemented. Hand to cashier and a box is pulled from behind the counter no dispensing cost occurred. Many items could be moved to a [P] line.
Otispunkmeyer said:
re paracetamol and ibuprofen etc
Why are we only allowed to buy 2 boxes in the UK? when in the US you can pop to Walgreen and buy a tub with 1000 tabs in it!
In case you try to OD. Presumably the geniuses who decided this somehow determined that no-one who wants to kill themselves will manage to go around several shops to get the tablets, perhaps over a week or two.... Like my neighbour for example who had about 15 packets of the stuff......Why are we only allowed to buy 2 boxes in the UK? when in the US you can pop to Walgreen and buy a tub with 1000 tabs in it!
Jasandjules said:
Otispunkmeyer said:
re paracetamol and ibuprofen etc
Why are we only allowed to buy 2 boxes in the UK? when in the US you can pop to Walgreen and buy a tub with 1000 tabs in it!
In case you try to OD. Presumably the geniuses who decided this somehow determined that no-one who wants to kill themselves will manage to go around several shops to get the tablets, perhaps over a week or two.... Like my neighbour for example who had about 15 packets of the stuff......Why are we only allowed to buy 2 boxes in the UK? when in the US you can pop to Walgreen and buy a tub with 1000 tabs in it!
Better if you can grab a funnel and pour one of these down your neck : https://images.app.goo.gl/uLfz3PuBUwzsV47o6
grumpy52 said:
Something came up locally about replacing bulbs in one of the local hospitals , part of a maintenance contract and the costs were horrendous, the trust were being charged 5X the price at a local suppliers plus a labour fee for fitting .
It worked out costing the trust £000s per day to have bulbs changed . Something that an in house maintenance team could have done for pennies under the old systems .
So that same in house maintenance team would have carried on changing bulbs at local supplier costs and out of the goodness of their hearts whilst foregoing salary, pension contributions, cost of living increases, sick pay, holiday pay etc?It worked out costing the trust £000s per day to have bulbs changed . Something that an in house maintenance team could have done for pennies under the old systems .
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