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 Some places have withdrawn pesonal smart cards and have store cards only, others are rolling out release 2 even though many people do not have release 1 and can't get one because the PCT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.