An edition of the Tyne Tees Television current affairs programme ‘Briefing’ that looks at modern medications which are being prescribed by General Practitioners across the region. Sheila Matheson’s report speaks with both doctors and pharmacists from Sunderland about the many issues they face making sure patients not only receive the correct drugs but also know how and why it is important to take them correctly and make them aware of any potential negative side effects. The programme also...

An edition of the Tyne Tees Television current affairs programme ‘Briefing’ that looks at modern medications which are being prescribed by General Practitioners across the region. Sheila Matheson’s report speaks with both doctors and pharmacists from Sunderland about the many issues they face making sure patients not only receive the correct drugs but also know how and why it is important to take them correctly and make them aware of any potential negative side effects. The programme also looks at the issue of wastage which is costing the National Health Service a lot of money and asking why doctors aren’t prescribing more generic drugs over the more expensive branded ones. Title: Tyne Tees An elderly woman talks with a district nurse about the various medications she is taking. Title: Briefing A man in his pyjamas opens his medicine cabinet and looks for a medication on the shelves, he picks up a bottle of tablets and takes them away. A doctor’s prescription being printed out by computer. The title of the programme written where details of the medication would have been added. Title: Just What Did the Doctor Order With a glass of water, the man takes one of the pills. To Pete Frampton of Humble Pie singing ‘I Don’t Need No Doctor’ a machines processes dozens of prescriptions and a mother giving her baby its medication. In an officer someone processes a large pile of fulfilled prescription forms changes to a man using an asthma inhaler. Someone using a calculator in an office change to a clean room at a pharmaceutical factory where a man in a protective suit pours a powder into a large mixer of liquid. On a computer screen a detailed analysis of the active drug compounds. Another worker at the factory pushes a trolley containing various trays into a fridge or freezer changing to machine that stamps out the medicine as tablets which drop down a chute into plastic buckets. A range of medicines lined up on a pharmacist shelf change to John Smith from the Faculty of Pharmaceutical Science at Sunderland Polytechnic explaining that as modern medicines are very complex if you don’t take them correctly you won’t get the correct benefits from them. In a laboratory John Smith explains to a group of his pharmaceutical students that some patients need to be given very basic advice, he explains that he believes many modern medicines are being wrongly used which is costing the National Health Service. The example he gives his students is the importance of water to wash down a tablet, he explains that some people aren’t aware of how to use a blister-pack in order to access their medication. Patients sit potentially in the waiting room of a Sunderland doctors practice, nearby a receptionist deal with patient appointments. A woman is called and directed to her consultation room. A second receptionist deals with a patient over the telephone. A Sunderland General Practitioner (GP) believes that people today are too dependent upon doctors with many coming into the surgery for minor illnesses which would get better on its own. People also expect more from GP’s because they provide more. The light on a display board lights up indicating to a patient that their doctor will see them now. In his consultation room the doctor seen previously chats with a mother about her daughter’s condition. As the doctor examines the girls throat and ear, in voiceover he explains that patients find the practice a relaxing place as it is familiar to them. He provides details on how he is works out a diagnosis of patient. The consultation over he writes a prescription and speaks with both mother and child and taking it. He explains that he doesn’t believe five minutes is enough time for a proper consultation. A timer counts down and the doctor sits at his desk writing a prescription handing it to the mother. He believes there is a lot of information he needs to pass onto a patient about their medication and there isn’t enough time to do so. He explains that doctors focus on the main points but rely on the pharmacist to provide more detail. A man walks out of his doctor’s surgery making his way to a nearby pharmacy. Back in his laboratory at Sunderland Polytechnic, John Smith explains that people often forget the instructions they have been given about the medication due to anxiety about the illness they have and so instructions need to be repeated time-and-time again. The mother and daughter seen with the doctor arrives at the practice dispensary to collect their medication. A large crowd of other patients sit or stand around waiting on their prescriptions to be filled. Handing the prescription to a pharmacist or assistant the form is processes and filled by several practitioners working at the dispensary. As the Head Pharmacist at the Sunderland practice talks about his relationship with the doctors, his assistants work to process more prescriptions which are coming through. He speaks with a patient about correctly using the medicine he is dispensing while at the back of the room a woman uses a machine to count out the correct number of tablets while a second uses a computer to process a prescription. A pharmacist calls over the mother to collect her daughter’s medication, she explains how and when best to be taken. John Smith believes there should be better communication between doctor, patient and pharmacist to get the maximum out of a medication. He also believes the information given out with medication is not adequate. At a W. Nimmo Chemist in Sunderland a woman hands over her prescription to an assistant who passes it to the pharmacist working at the back of the shop. Using a computer, he prints out the labels before sticking them on the medicine box, placing that into a paper bag and taking it out to the patient. He explains to her that there is a leaflet in the packaging about the medicine after which she leaves. The Sunderland GP featured previously talks about how modern labelling contains far more information than in the past. As he talks about how a pharmacist can have a positive relationship with a patient and the important work they do to assist the doctor, the pharmacist at W. Nimmo Chemist fills out another prescription printing labels while an assistant fills a bottle with the correctly counted tablets. As the pills are passed to the waiting patient the Head Pharmacist explains how it is to be taken, in voiceover he explains that he can only prescribe medication as instructed by the doctor, even if they believe the doctor is in error or wrong. The doctor has the ultimate right to prescribe whatever they feels is necessary. At the top of a prescription form a section to indicate the number of days the medicine should be taken. The Head Pharmacist explaining that few doctors use this part of the form with most ordering in quantity. By using the box, he believes it would reduce drug costs and wastage which are often significantly higher than current prescription charges of £1.60 per item. The Head Pharmacist prints out several labels relating to one patient sticking one onto a bottle. He explains that often patients have more than one mediation which may react negatively when used together. He is concerned that doctors don’t aways explain these risks to patient of drug interactions when the prescription s written. The Head Pharmacist completes another prescription and takes it out to the waiting patient, again he gives detailed instruction on how the inhaler being prescribed should be taken. Outside a local Health Centre people coming and going from the surgery, the Head Pharmacist holds up a number of prescriptions which he believes were for patients who may not have seen a doctor and were possibly written by a receptionist. This is a practice he greatly disapproves of. Back at the Sunderland GP surgery receptionists dealing with patients, in another part of the surgery a woman typing a letter. The Sunderland GP explains who the surgery couldn’t function without receptionists, but he believes they shouldn’t be making clinical judgements. They do write and prescribe medications, but these are checked by the doctors at the surgery first. A receptionist places a floppy-disc into a drive and inputs patient data into a computer. The GP explains his support for the use of computers in his surgery as it takes away some of the drudgery of dealing with repeat prescriptions and, he hopes, will one day be where all his patient records will be stored. Returning to the Head Pharmacist his concern is with regards people, especially the elderly, on repeat prescriptions and on more than one medication that the labelling in inadequate as there is nothing on the label that would indicate to a patient how to take it properly or about any potential drug interactions. A local District Nurse Sister Anne Russell explains that elderly patients do get confused with regards the amounts and times of the medicines they are taking. They often also have phobias with regards tablets. She arrives at the home of one of her elderly patients going inside to finding her in the living room says hello. Sister Russell speaks with the woman about her condition and the two of them look over a colour coded medicine chart she has produced to help her know when and how to take her many medications. In voiceover Sister Russell provides details about how this chart works and about its value to her elderly patients. The older woman explains the problems she has with the child-proof lids on bottles, she them shows how she opens a bottle. Examples of easier to open bottle tops available at most pharmacists, a pair of hands show how one of these caps works. Another helpful tool is the pill organiser with pills being places into one of the four daily slots. The Sunderland GP explains that it is human nature for people to forget things while John Smith explains it is a major problem that patients forget to take their medication as it causes a lot of wastage. The first part of the programme ends with the man seen at the start of the programme placing his tablet bottle back into the medicine cabinet. Title: End of Part One Part Two The camera travels along the corridor of a medical research facility stopping beside a window. On the other side two researchers wearing protective outfits and working in a clean room remove vials from a machine. Sitting in a living room an older woman removes a tablet from its packaging and drops it into a glass of water, it begins to dissolve. With the tablet dissolved she drinks it. In a consultation room a doctor speaks with his patient changes to show a yellow report card which are used by doctors to report drugs that have adverse effects on their patients. On a shelf bottles and little red tablets of Phenylbutazone, an anti-inflammatory drug that has recently been withdrawn. An ambulance parked outside the Outpatient department of the Royal Victoria Infirmary (RVI) in Newcastle. Inside the hospital pharmacy a pharmacist uses a tablet counter to fill a prescription bottle. On a table two bottle containing different blood pressure tablets, Aldamet which is the branded version of Methyldopa and costs twice as much at £5.57 per 100 tablets compared to Methyldopa’s £2.26. In a community pharmacy a woman using a machine to count out tablets filling several bottles. Dr Andrew Smith explains that the only way to get a GP to prescribe a generic drug would be to either pay them to do so of fine them if they do not. In the Tyne Tees Television studio in Newcastle presenter Ian Breach leads a discussion on the issues raised in this report with General Practitioner Dr John Noble, Dr Nick Bateman a Clinical Pharmacologist at the Freeman Hospital in Newcastle, and Dr Peter Read from the Association of British Pharmaceutical Industries. Ian Breach brings both the discussion and programme to an end. Credit: Narrator Sheila Matheson Film Production Team Alan Anderson, George Bush, John Cook, Fred Crone, Roy Deane, Richard Edwards, Ed Gray, Bernard Helm, Mark Lavender, Karen McPherson, Paul Rickard, Joe Smyth, David Thomasson Studio Director Rob Cowley Producer Bob Farnworth End title: Tyne Tees Colour. © Tyne Tees Television Ltd. MCMLXXXIV