Dance of the lemmings?

I could be polite. But I shan't be. You have been warned.

What a bunch of utter pillocks we must look to the outside world, let alone to DoH, Commissioning GP bodies and everyone else who likes a good laugh at some inept set of individuals making a mockery of themselves in public.

Positions on comissioning bodies as a matter of right? Only for the position of Court Jester, these hard pressed people in charge of delivering healthcare under the worst financial constraints since the end of World War Two could do with a moment or two of mirth, and we're there to provide it.

In case you are at all unclear at what I refer to, click on the following link to read the full and bizarre truth about the morons we pharmacists are.

http://links.mkt2859.com/ctt?kn=44&m=36077401&r=NjU3NzMyODM4NgS2&b=0&j=ODk1NTI0MjQS1&mt=1&rt=0

If it doesn't work, e-mail me and I'll repost the thing. Unbelievable what a set of plonkers we are!

Some of us have taken it upon ourselves to report ourselved for poor performance. How noble! How gallant! How sh1t for brains f%^$£$&G stupid can we get? On second thoughts, please, NOBODY ANSWER THAT! We might regret it even more. Any volunteers for a red hot poker up the jacksie? Yes! Silly b*&^^%r pharmacists will try that. Anything for a laugh those chums of ours, I can hear them say.

What about the future? Forget it! With clowns like these, who needs water pistols? At least they aren't real guns, then we could shoot ourselves in both feet. But as usual, being so inept, we'd probably miss! Cause to report ourselves for poor performance?

How have we come to this?

Eggs on the lawn at dawn?

It's a Lancashire New Years Eve/Day tradition, probably replicated elsewhere in the country. Following the excesses of New Years Eve, breakfast on the New Year Dawn is welcome to many.

It's 23rd November and if I hear one more in-store Christmas song, hymn or other ditty, I might just fail to resist the temptation to turn these items into a suppository! The television and radio obsess with unrepeatable deals (until next time) and "must-have" items for all.

We don't get this nonsense for Diwali, Ramadan or any other "faith" group celebration. I use the terms "faith group" advisedly, not to insult anyone. Christmas is a Christian festival to commemorate the birth of the Christ, if that's what you believe in. I can't quite figure out where the excesses of finance, gluttony, alcohol, spending money people don't have, on things the recipients don't want, let alone to consider the so called "entertainment" on television? Get me out of here, I've had enough already.

As the good Mr Ebeneezer Scrooge said, "Celebrate Christmas in your way, and leave me to celebrate it in mine".

So in the true spirit of the Season of Goodwill to All Men (are women excluded?- my life will be even more miserable at Christmas if so!) Easter 2011 will fall on Sunday 24th April 2011. A Happy Easter to all, and please note that in the New Year you will be able to order on-line from our new on-line sweet shop. It was going to be called "Get Stuffed with chocolate", but we had a rethink, as it sounded a little aggressive. I reckon we're the first to get in with Easter next year. Beaten Marks & Sparks, anyway. This isn't just Easter, this is NPS Easter.

By the way, even though these events come around every year, why is it that so many companies seem caught out and struggle to cover the dates around Christmas and Easter, let alone summer holidays? Saving money? Don't think so. Book it now, have done with it and enjoy a mortar and pestle shaped "morsel" from our portfolio.

Happy Halloween to you all - it's in the pipeline! Only 300 and something days to go. Get your trick or treats ready now, at special unrepeatable prices.

Inciting terrorism?

On all the news channels, newspapers and media, it seems that we in England at least have sunk to a new low! A plot is uncovered to strike at the heart of our democracy, religious zealots hijacking the cause of religion to turn the mainstream majority into a frenzy of hatred. We are at the highest state of alert, with all the forces of national security and state machinery being turned against the suspected perpetrators of such an awful plot.

Sounds familiar, it could be any day since 9/11 or 7/7.

Worse, there are many who celebrate! They party, they commemorate that the thought of this potential outrage, this terrorist atrocity, this audacious attempt to set citizen against citizen, to fuel racial and religious hatred the world over. It is truly a scandal. And yet there is the potential for these horrible people to be remembered long after the meaning of what they believed in, that which led them to believe in their hearts that the ends justified the means, to enter into the collective memory and be celebrated, to be glorified, not vilified. The people of New York, of Mumbai, or Darfour, will remember crucial dates for ever, the dates etched into their hearts with sadness, with memories of innocent loved ones lost in ultimately pointless acts of evil. Time heals these wounds, it appears. Let us hope so.

London and Britain remember too, what could have been the greatest terrorist atrocity of all on these shores, had it succeeded. 5/11.

Remember, remember, the fifth of November, gunpowder, treason and plot. Are we guilty as charged?

Halloween horrors

It nust be Halloween when the usual trick or treat brigade venture out.

I'm talking about the ongoing process where both locums and agencies are coming in for an onslaught of derision and devaluation without any prominence being given to the reality of locum life in pharmacy.

Those publications that I have written to or otherwise contacted over the past few nonths, asking that they allow a balanced response or rebuttal to claims that locums are of poor quality, offer poor value for money, won't provide services and any other faulire within pharmacy to get it's act together, include people who should know better. Not just because they are pharmacists, because not all are. Not just because editors have a responsibility to provide balance to articles, letters and features which appear in their publications. Not even because many vested interests have their own agenda and are using this issue as one of many smokescreens for what our "leadership" (whoever or whatever they are) are failing to address - let's not go there just now, my soap box is in for repair.

By failing to bring the profession together in the way that the doctors, nurses and other professionals have achieved, we remain weak politically, within the negotiating sphere and within the areas where we need to make our voice heard. If we do not, the profession is heading down a blind alley, an evolutionary cul de sac, and we won't exist in the form we recognise, if we exist at all, in another five to ten years.

Over the years we at NPS have got used to hearing from pharmacists, be they locums, managers, owners, about how they can't wait for the next few years to be over so they can pack in, as they have had enough of the way things are going, of how interference from outside the profession by people who just do not comprehend what issues are involved in our work is damaging, not improving what we do. We have got used to may experienced pharmacists expressing frustration with not feeling able to do their job the way they believe and know from experience, how it should be done, and who state "If I could find something else to do which kept me and my family as comfortable financially as this job, I'd do it tomorrow".

That is really sad, but it's worse to hear it from pharmacists who only qualified a few months ago! These people really are looking for something else and will take it, even if it means retraining. What a waste, what a shame, what a scandal.

Are you happy to be one of the so called "lazy locums" when you know you're not? Are you happy to carry out MUR's, EHC, Smoking Cessation, Minor Ailments, Repeat Dispensing, Electronic Transfer and so on, when you hear that locums won't provide these services?

We need to unite behind an idea and a principle that does not divide us, with the result that we are always conquerd. We need to take back our agenda, think it through, take it out to people, prove it can work and then make it happen, not wait for some pen pusher who wouldn't know a patient if they fell over one on their way to the next vital meeting.

Time to go, the trick or treaters are at the door!

In the kingdom of blind cynicism, the one eyed man is king.

We seem to liver in a world, or at least a country, where cynicism is a way of life. The spending cuts recently announced were inevitable, whoever won the last election. It was always a question of how much, how quickly, and not, "we mustn't cut spending". The media, however, have gone off on their rabble rousing activities where even the impartial BBC keep asking us "What's fair for you - are you a winner or a loser?" Maybe we should ask the French or the Greeks what is fair and what isn't.

How many times have you come across a situation where a customer asks you for change? The common stock response, or politely drafted head office answer is "I'm sorry, but we aren't allowed to open the till unless it's to make a sale", which really means "No, we're a pharmacy, we supply medicines. I think it's the bank you want, why not go and ask them for your change?"

On one of my weekly days of work in the real world as opposed to the office, what I like to think of as my "back to the floor" task, I recently got asked the very question. No, not "Is it fair?", but, "Could you possibly change this £5 note into £1 coins for me?" As I was working in someone elses pharmacy, I asked the dispenser whether the company allowed us to do so. I didn't want to get anyone in trouble for acting on my own initiative, nor to set a precedent for the future which might be uncomfortable for all concerned. I didn't get the answer to the question, she simply checked the change tin and swapped the note for the coins and carried on with what she had been doing.

The elderly lady seemed rather pleased and thanked us profusely, wandered about the small sales area and perused the shelves for a moment or two, then shuffled towards the exit, wishing us a very good day and thanking us again. Just before the door, she stopped by the till and carefully put the five £1 coins into the Macmillan Charity Box, and walked away without looking back.

Of course, businesses have to pay at the bank when they put in a change request, so there will have been some financial cost to that business in handing over the five £1 coins, even though the powers that be there may never know it took place, would they have sanctioned the "transaction" had they known?

Coincidentally, less than an hour later, two representatives of the charity came in and asked to empty the box. I recounted my tale of the coins and asked whether they accepted notes in the boxes. They weren't entirely sure but felt that any donation would be acceptable, whatever the form, as I'm sure we all would. Our conversation drifted round to all the good work done by this and other charities, and whether the government understood just how much people depended on services such as those provided by Macmillan. Anyone who has would understand immediately that their work is priceless, but we also concluded that people would do good works not because of the payment, but because only another human, not a government, can understand how much a hand to hold when you are lonely, or a voice at the other end of a telephone when you don't know what to do next, can transform your world.

The ladies were delighted with the money they had collected from the charity box. For the record, it was around £38. If every box they emptied contained as much as this, they explained, we could do so much more. "It just shows that there are a lot of good people out there", they concluded as they were leaving. I am left wondering how many charity boxes around the country are all the more poor because the owner or manager of the premises refuses to give change unless they open the till for a sale.

The power of unity

Only a person with a heart of stone could not fail to be moved at the plight of los 33, the Chilean miners who this morning were all saved from their underground prison and walked into the promised land of Camp Hope. Perhaps once in a generation, an event where the prayers, belief, empathy of the world unite behind a group of fellow human beings trapped in a struggle to survive against apparently impossible odds. The last time I recall such a world wide event of this nature was the Apollo 13 moonshot.

Both the miners and astronauts had a number of factors working together in their favour. The individuals were united in their determination that they would survive. They were united in their trust in those working tirelessly on their behalf, to think the unthinkable and come up with some ingenious answers, previously never considered, to move heaven and earth and bring them safely home to their loved ones. How they delivered the impossible!

Unity is an amazing concept, hence the phrase "Divide and conquer". All the miners pulled together and worked together in their own way to ensure that as a group, they were in the best circumstance to react positively when the moment of their deliverance came. The unshakable belief of both them and all the support workers and families, so long camped above the mine, that they were all working together for a common aim, that they would succeed against all odds, is inspiring to us all.

We could all learn a little bit from hope, belief and unity. Let's hope none of us is ever in a situation like the Apollo 13 crew or los 33 to have to learn for ourselves what it takes to face the unknown and walk away intact. But just in case, perhaps tomorrow, we should take a first step towards it. We shouldn't waste our chances, as one day, we might be so fortunate as them.

Publish and be damned!

We've had a number of difficulties to deal with over the past couple of months which we have kept to ourselves, but have now resolved (we hope!) and some of these along with other things we wanted to tell people have been featured in our e-newsletter for October 2010, which was sent to anyone on our mailing list last night.

If you haven't received a copy, it is because you are not on the list. A copy will be available from our website next week, but if you want to receive a copy before then, along with future e-newsletters, please get in touch and provide us with your e-mail address.

As is ever the case with these new ideas, things didn't go quite to plan. On the plus side, it only took eleven minutes to send to a few thousand people and we didn't cause any servers to crash, as far as we know.

One or two people did receive more than one e-mail, as they were in the mailing list more than once and although we did try to check to prevent this, as it was a manual check (no women took part in the checking), inevitably, it was bound to be imperfect. One lucky person did receive twenty six e-mails, all attaching the newsletter. However, as this happened to be our IT manager, it wasn't too big a deal. We analysed the problem to try to prevent future similar episodes and concluded the fault lay with the nut on the keyboard.

The point of using the newsletter is to quickly and comprehensively get across to a large audience information which would take us a long time to repeat to everyone and which may not always be relevant to each and everyone of us. In addition to communicating information via our website, which is averaging 60 000 hits a month and growing, it gives us chance to promote ideas, especially at a time when individuals in the world of pharmacy appear to be being crowded out and having their voices drowned out by big organisations.

Both we, and you, need to make our voices heard and not continue to allow events to overtake us or move us in directions which we do wish to go and more importantly, which we know to be wrong for the profession and the people whom we collectively serve. Together, we are stronger than any of us could possibly be alone. We should remember that.

Little Boy reaches 65 years old - time to give up or get up?

The idea that the retirement age is being raised from 65 years of age because we are all living longer and that retirement was something most people never saw when the retirement provision was originally constructed.

Shakespeares Seven Ages of Man shows us that little boys have time to play, where play is the work of children, whilst as we pass our prime, we would like time to play more rather than work, but it all has to be paid for somewhere along the line. The worst aspect of judging people by age is that young people often disregard their elders as short of knowledge of the "modern" world based on their experience of six score years of life. Not long ago I had blazing rows with "minor" employees of some PCTs who wanted to "get rid of the old codgers" from the world of pharmacy. Many (codgers) obliged as they were smart and realised we had moved to a scenario where their knowledge and experience would never be acknowledged, and many resigned from the register (of Pharmaceutical Chemists). They were smart enough to see that we were being led by little boys and were following, like lemmings, over the cliff edge. We didn't bother to ask them what they thought, we assumed they were past it. Now, however, we cannot make that choice and must continue to work, even if we don't want to and are not wanted when and if we reach that milestone.

After all, they had been through it all before and built what we inherited and are now bodging due to our relative lack of experience. Does history teach us it's mistakes? Of course! Do we learn them? No!

What was the main news today in all the papers and media? Not the fact that 65 years ago today, Enola Gay dropped Little Boy on the city of Hiroshima, Japan. An estimated 140,000 people were killed instantly or died from the effects of radiation in the months that followed. A further 80,000 people died after the US dropped an atomic bomb on Nagasaki three days later.
The US has since justified the bombings as an alternative to a potentially prolonged and costly land invasion, saying the devastation wrought on the cities forced Japan's surrender days later, on 15 August.
Some of the 55,000 people attending today's ceremony of remembrance made symbolic offerings of water to the victims, as many had complained of thirst as they lay dying, while schoolchildren read out messages of peace. A single bell tolled as the city's people fell silent at 8:15am, the exact time "Little Boy" detonated.

The day that changed the world forever barely warrants a mention today, 6th August 2010. Would we dare sanction the dropping of a nuclear bomb on anyone today? Since the answer is a resounding "NO!", even though we can't be bothered to ask those who were there, the witnesses of Hiroshima and Nagasaki, why should we bother to ask anyone who has been there before in terms of pharmacy in the UK?

So why would the "leadership" who have claimed us as their "membership" without it ever occurring to them that we might not actually want them to lead us anywhere, as we didn't ask for them in the first place (less than 1 in 5 voted for a change, let me remind us all). This isn't a nuclear bomb - that would be a gross insult to everyone involved in events 65 years ago today. But is a a depth charge, silent running and it will come back to haunt us all if we don't face it down. Is it time for a DIFFERENT new professional body? Some think it is and they range from little boys to over 65 years old and more. Could this be a coalition OF THE WILLING?

P.S. I can't be bothered labelling this post. Technology! Why can't id do it for me?

Smart Cards or Smart People?

The news that an estimated 200 000 patients are at risk because of inaccurate data in their Care Records has led to GP leaders calling for an immediate halt to the Governments Summary Care Record programme. What's worse, the majority of these care records have been created and uploaded without patients consent.

It appears that the gaps and innacuracies, such as wrong medication or allergies result largely from operators not having the required smart cards to gain access to the system.

Some PCT areas and some LPCs are promoting the requirement of smart cards for pharmacists as mandatory, others are not remotely interested, creating wide differences in day to day working practices accross the country. Add to this the shambolic approach to facilitating the issue of smart cards by different PCTs, it might just be that as the new government decides to save billions of pounds and scrap failing IT projects, this dislocated approach to smart card issue and use accross professions mirrors that of PCTs, may result in the whole project falling flat on ITs feet.

This is not because it doesn't work - it clearly does when set up properly and people get involved. It's that bad old bueracracy again. If only organisations like the NHS stopped running themselves to suit the organisations priorities and focussed on patients priorities, huge and expensive messes like the Summary Care Records fiasco might be avoided and nmore importantly, patients might feel the NHS is there for their benefit.

For years when we have been working with PCTs, Nightingale Pharmacy Services have always striven to get PCTs to understand that pharmacists work accross several PCT boundaries and they need to recognise that patients do too. Trying to get some of the PCT staff to understand that pharmacists can't deliver the patient care they want if the PCT doesn't understand that we work in this way and do nothing to support us and enable us to provide the services we want to.

At least with pharmacy we know where we stand - if we give poor service, the patient can always vote with their feet and go somewhere else. So people are smart and can react accordingly. Cards are not smart.

this twittering world

"Not here the darkness, in this twittering world.

Descend lower, descend only
Into the world of perpetual solitude"

Not my words, you understand, those of T. S. Eliot who was obviously onto something. If twittering ws good enough for Eliot, I suppose it's good enough for me. Don't think he would have settled for 140 characterrs, though.

The full text is from a quartet of poems, "Burnt Norton". Something to make you stop and think though I don't think it will class as CPD but......

Shooting ourselves in both feet.

So, there we have it. The first salvos that tell us we're in for our own winter of discontent. The propoganda war starts today. Not that Pharmacists will (or should) go on strike, and yes, despite a typo error on my Profile on our "new project", as I'm not 31 years old and was 18 in the year Thatcher came to power, I do remember the original "winter of discontent" and Britain being the "sick man of Europe). Happy days!

The news that GP's are likely to see their pay cut by a quarter can only be bad news for pharmacy.


http://www.pulsetoday.co.uk/story.asp?storycode=4126456&cid=Latest_headlines_1_010710


It's a line in the sand that multiples in particular will clutch and hold on to for grim death, noting that despite the "recession" (aka "a time when people don't buy what they don't need") one of them has posted third year double digit profits. Times must be tough!

We have been advised that one of them is cutting a pound an hour off all locum rates in mid-September, or a 4.54% pay cut BEFORE inflation and IGNORING the 6% year on year prescription volume increase they are likely to get just by organic growth, ignoring again self generated growth (if they have any). So, 6% more work for you for 4.54% LESS pay. Doesn't seem fair, does it? But we're all having to share the pain, aren't we, I hear you say. Not really, we say. Double digit growth means more than 10 %, so somewhere, someone doesn't understand percentages. It could be worse, we could do it in fractions. Ah! I hear you sigh. So what's the answer?

We've said it before and we'll say it again. Vene, Vedi, Vici.

I said we'd been around for a long time. I came, I saw, I conquered. But who thought of Divide and rule? Works every time.

We have terms and conditions, like everyone else. It doesn't matter if some pharmacists break them, does it? Book direct through us and don't tell the agency, and you'll be better off, trust me! Nudge nudge, wink wink. And you're better off! Miraculous! Whilst it lasts, then the calls dry up, then you've no work, then they say, "Tell you what, seeing it's you, we'll do you a favour". You breathe a sigh of relief, before choking at what comes next. "We've had to drop the rates though, you understand, there's a recession on" You fall silent. "Of course, if you don't want it, we've got locums and other agencies queuing up for it...". Then, finally ,despite everything we've told you, you finally realise the truth. You've been mugged. Take a couple of pounds an hour pay cut or get no work. No brainer. Not really - the no-brainer was not listening to our years of experience.

Still, no one died. True, but that's only because pharmacists in the main don't have guns. Human beings normally shoot themselves in the foot. I must have missed those sessions at Uni which taught the rest of my colleagues how to use a gun, since too many are superb when it comes to shooting ourselves in both feet.

In case anyone reading this masitakes these observations for bitterness, forget it. We've been around for over 16 years doing this, and we know how it works, so bitterness was overcome by reality many years ago. Frustration, though, that it always seems to end this way? You could be onto something there. Answer? In the name of everything that is Holy, do not give Pharmacists guns, or we've all had it!

They don't like it up@em!

..as Corporal Jones would say.

It appears that some of our Members of Parliament don't like their new expenses system. Apparently, they have to pay for their expenses up front, keep receipts, then try to claim their expenses back and it's simply not on, according to M.P.'s.

So, let's consider this for a moment. M.P.'s, who are paid by us, who raise money through taxes on us which we pay by having to submit details of income and expenses via Her Majestys Revenue and Customs, don't like the fact that they (like us) have to pay for expenses they incur in respect of their work, and have to claim the money back. At least they get it back! How much does your accountant allow through on the basis that "the Revenue don't like that"?

Then there's the issue that some of have to contend with, VAT returns, tax returns, PAYE/NIC records and payments, SSP/SMP/SPP, which are usually done outside of work hours, aka Sunday.

At least our hard pressed M.P.'s have an army of people to help them -77 in total, managing the claims of 600 or so M.P.'s. We have to pay our accountants, they aren't provided to us like the M.P.S's get.

Maybe they can find time to pass less stupid laws in the next few years, as they'll be too busy to work in Paliament for having to reclaim the second home allowance! Whilst they're at it, maybe they could repeal a few laws or bring them into line with others.

Let's start here - if an M.P. makes a mistake, they should face a jail sentence, with maybe a warning only if they make a single mistake. That would bring them into line with us Pharmacists, who can be jailed for a dispensing error.

Alternatively, they could change the law to stop us being prosecuted for a mistake. Maybe we would all sleep a little better then. What has the New Professional Body got to say about this idea? Have they raised this matter with our M.P.'s?

We're waiting.........

I've seen the future and I don't like it!

According to Pulse Today, GPs legal representatives are very concerned about changes to GP fitness to practice hearings being fast tracked. There is a new body replacing the GMC body which fomerly handled such cases and there are concerns that GP's may not be properly represented in such circumstances.

There is a chilling parallel to our own situation here - nobody sets out to be incompetent or inadequate, surely. But the question I am increasingly being asked by colleagues, whether locums, managers, pharmacy owners, is "is there something that we keep me as comfortable as my present income does, because it's becoming a real worry that just doing our jobs could lead us into trouble?"

Follow the link to the article below and see what I mean. Surely, if GPs are worried now, as well as pharmacists, where are the people going to come from to continue operating our professions and the services which we provide in good faith, if we are too frightened to act. So much for a Code of Ethics. We seem damned if we do and damned if we don't.

In the perscution of so called "witches" in the 1600s, witchfinders stated that "good" witches (those who used herbs to cure ailments, or called charms to resolve a worry) were more evil than "bad" witches, (those who used their "powers and skills" for malevolent purposes), and thus the "good" witches deserved greater perscution that the "bad" witches.

That was 400 years ago. What it must be like to live in "enlightened times"!


Fears over introduction of 'fast-track' GP fitness to practise hearings

http://www.pulsetoday.co.uk/story.asp?storycode=4126443&encCode=7546292312BC559139429JTBS737226611

RESPONSIBLE PHARMACIST NOTICE - it'a free.

Yes folks it's true!

We know things appear to have been quiet this past moth or two, but in the background we've been working on the web site and a number of new features are ready or nearly ready.

Weve started with some simple and basic things and yes, they're free!

Have you got to a pharmacy to discover you've forgotten your Responsible Pharmacist Notice, or got home and realised you've left it at the pharmacy you've just been working at and won't be due there again for a while?

We all know we have to display the notice, or we are committing a criminal offence, so what do you do (apart from panic and hope the Inspector doesn't call today)?

It's easy!! Go to our web site www.locumpharmacistuk.com and click on the link to downloads and hey-presto, caramba, golly! You can enter your details and print off a Responsible Pharmacist Notice for the day, or whenever you need one.

Other handy downloads are a Locum Invoice if you need to submit your claim and have not got one available or have left yours at home, as well as your Responsible Pharmacist Notice.

There's a Duty Pharmacist Report template too - much better than leaving a load of Post-its, and you can take a copy of what you have put on your report in case you need to refer to it later.

What's that you say? You can't download these files? Well our clever IT Web Monkey has added a FREE Adobe Reader download to solve that problem too! So there you are, useful, practical tools to offer sensible solutions to the day to dat crises we all face on occasion.

Simples!

Check these out but don't forget to keep checking back, as we will gradually be releasing improved versions of the site with new features including your own Private Page, which will allow access to a range of additional features, from your on-line diary, accounts management and a whole lot more.

What to do when the roof caves in?

Just when we think spring's on the way, it decides to rain and rain and rain. Then it got through the ceiling of the office above and eventually it comes through our ceiling and the ceiling collapses on us!

Having cleaned off the wet plaster and dusted down the keyboards, we've had to make a temporary relocation to try to manage. The main telephone line of 01482 - 863172 remains operational - if anyone has previously used any of our extension numbers (475195, 475196 etc), these will not work for much longer, so please continue to use the main number.

E-mail and text services remain intact, but for a couple of weeks, speeds might be slower than usual, so please bear with us. A new Post Office Box (P.O. Box) number will be soon used for correspondence and we will announce any other changes via the web site as they occur.

Thanks to the person who offered us the use of their delapidated barn! We're very touched.

Further news on it's way as and when we know it.

Linda and Stephen

ARE WE THERE YET?

Changing things for the better and making improvements are usually best described as being a "process" rather than an "event".

When we decided, eighteen months ago to completetly change our way of working and to create an interactive web site for locums and clients to use, we had no idea how much of a job we were letting ourselves in for.

To have reached the point where we are at today, which is not yet near finishing what we started, our simple idea has taken on a life of it's own and reached a dizzying level of complexity.

We've often said that when something works well and easily, it's because a lot of hard work has gone ito making it look easy. If anyone would have asked us 18 months back, did we expect to be getting 60 000 hits on the web site every month, we'd have thought that they were mad. What's more surprising now, looking back, is that 60 000 plus hits a month and rising steadily has not caused the whole thing to crash! If you wonder what I mean, 60 000 hits means there have been 60 000 occasions in a month when people have looked at our web site.

That's a lot of looks, for something that is still under development and has so much more yet to be added! Still, even now, locums can log in and add their own availability to increase their chances of picking up work, check out enquiries for work in their area on any given day and even be able to e-mail into us from the web site about any vacancy which interests them.

With the best yet to come, it will be interesting to see what other interest is attracted. Advertising will certainly follow, and before long we hope to have the "Private Members Area" up and running, where registered users will be able to log in and access a much wider range of features and services.

If there is anything you would like to see on there, please get in touch and keep us informed. It may be that advice on accountancy would be helpful, or maybe educational features. What about a "Swap shop" where you can exchange goods or unwanted items, or for excess stock from your pharmacy to be turned to profitable use by exchanging with another pharmacy? All ideas are up for consideration, so why not let us know what you think would be good? With so many people coming to the site now, there must be a lot of scope for us to offer you what you want or need.

It's not often you get something for nothing in this life, is it?

Post code rationing - what's smart about smart cards?

So the endless frustration with commissioners of health care goes on, especially for pharmacy. A quick interogation of our database shows that on average, a locum pharmacist will work across ten PCT areas over a period of time, many of whom have come up with "local" schemes for EHC or Minor Ailments. The vast majority of locums, like their permanently employed colleagues, want to provide a full range of services wherever they work.

I may live a sheltered existence, but how is unprotected sex which requires EHC any different from one part of the country to another. We had some meetings in London this week and came away frustrated at the inflexibility of different PCTs to recognise a basic or "core" accreditation for EHC, with local variations built in e.g. some will provide the service via pharmacies only to under 19 year olds, others include condom supply, still others are providing material to "demonstrate" to youngsters how to put a condom on to a model of the "real thing" (I'm being as tactful as I can, if anyone dosen't know what I mean, please e-mail and I'll clarify in a more broad minded description; e-mail details on the main site).

I digress at this point. Back on message. Why on earth do we, allegedly well trained, motivated, professionals, who continually update our skills and expertise. The bulk of the questioning and advice and responses we go through are the same from one place to another, some minor local variations on procedure are not beyond our wit to recognise these. Perhaps we sign a fax and send it to say we've read protocols and let's get on with it. Why do I have to turn away a patient in Haringey because I haven't done their local training session but I can do so in Hartlepool?

Then there are smart cards - what's smart about them? Some places have withdrawn pesonal smart cards and have store cards only, others are rolling out release 2 even though many people do not have release 1 and can't get one because the PCT isn't providing them when it's convenient to the pharmacist to get there, and on it goes.

Whilst it's nigglig for us and inconvenient, the patients must wonder what the NHS is about sometimes. Can't get the morning after pill here but you can across the road, why? It's a different PCT, obviously.

You'll soon be able to air your views via our Members Area of the web site. Keep visiting as it will be along soon, along with a host of new things such as your own Private Area, on line booking and diary, Pharmacy Finder. I could go on, but you'll see soon enough.