Distribution: Medication

Some, especially the ill and elderly need to take regular medication but find it difficult to get out to a chemists and/or are not good at remembering to take the dosages regularly.

This section discusses:

Existing Provision

What

A significant proportion of the population is on regular medication. They currently need to:

How

The very ill and housebound have nurses and carers who visit them and ensure that they take their medication. Many others rely on friends and neighbours to help them get to the chemist (pharmacy) when needed. Some find it difficult to remember what to take when. This can result in them failing to take essential drugs or, just as dangerous, be at risk of overdosing should they take too much.

Even if the patient is perfectly capable of taking the right quantities at the right time, there are many classes of drugs that are very attractive to addicts and could be abused by other members of their family or even make them a target for criminals desperate for a “fix” or keen to steal their drugs to sell on.

Volume and Frequency

Ideally,

Financial Model

Prescriptions are free but it often costs pensioners both time and money - as well as physical discomfort in many cases - to get to their pharmacy for new supplies.

It also costs doctors and the NHS time and money to keep writing out and processing repeat prescriptions. While regular review of patients' needs is important, in many cases the need for a repeat prescription is simply because the number of pills in a packet is limited yet the condition is persistent.

Providers

Each LocalHub could probably support a small pharmacy that holds stocks of the drugs needed by the residents in its catchment area. As preparing each residents' doses for the next day can be done at any time during the day, a single pharmacist could easily also manage a retail counter allowing residents passing through or visiting the LocalHub to have access to their advice and over the counter medicines during business hours. Where a full-time pharmacist is not justified, dosages may be sent from a neighbouring hub and/or a single pharmacist may work at different LocalHubs on different days of the week.

Trends

As the proportion of elderly in the population increases - especially with significant rises in dementia - it becomes increasingly important yet at the same time more challenging to let people retain their independence and live in their own homes where this makes sense. This service, along with the Contact and Treatment services should help achieve this goal.

With Localnet

What

With localnet, provision of drugs will be

Repeat prescriptions will be a thing of the past. Doctors will set a date at which medication should be reviewed - irrespective of the size of bottle or packet the pills happen to retail in.

How

As localnet deliveries are made to every dwelling at least once a day, it becomes viable to include the day's dosage while delivering other items to the dwelling.

Small envelopes or pots containing the requisite dose will be prepared the previous day - by a local pharmacist or by an automated dispenser should volumes justify this.

Volume and Frequency

For most, the PaperBox and/or MealBox that is delivered each morning will contain the day's dosage - ideally in clearly labelled and probably colour coded pots or envelopes.

Patients with difficulty remembering to take additional doses during the day could have midday or other dosages delivered and, if necessary, be helped to take them without diverting vans far from the routes they would otherwise be taking anyway.

Financial Model

This should probably be a free service to anyone on medication. The savings made in out of date, stolen or abused drugs plus the improved treatment results that should arise from regular doses should make this a net benefit to the community

Providers

Local pharmacies should be involved in the dispensary process at each LocalHub.

Evolution

Packaging of drugs may change if the dominant method of dispensing them becomes to provide a single dose (or day's supply) rather than a box or packet suitable for a full course of treatment. This needs to be done in such a way that the per dose packaging is no more wasteful than the current approach.

 

Comparison

The table below assesses the impact of localnet on this service on a scale of -5 to +5 (details here)

  Existing services As part of localnet Score
Scope Informal from friends and relatives or expensive care services. Adds a light, cost effective touch suitable for those needing some help. +2
Frequency Cost of visiting makes it difficult to do daily for many. Daily or more frequent. +3
Security Pots of pills vulnerable to abuse and theft. No stocks of drugs in homes. +4
Convenience Hard to get to pharmacy for many. Drugs come to you when needed. +3
Cost Travel costs. Free at point of delivery. +3
Quality Depends on patient or those around them to ensure regular and correct dose. Exact dose presented daily or twice daily guaranteed. +4
Carbon Footprint Travelling to chemist every few weeks and/or having care worker visit frequently. Negligible extra transport costs on delivery being made anyway. +4
Time Can be a slow and painful journey to chemists. No effort at all on part of patient. +3
Resources Used Bottles and packaging. Simple wrap or reusable pot. +1
Reuse & Recycling Glass bottles to be recovered. Reusable pots put back in the box they came in as soon as they have been used. +1
Landfill Waste Medium term protection requires plastic and foil wrapping for some. Shorter term, all pills to be taken together in one simple recyclable envelope that is put back in container immediately after emptying. +1
Other Differentiators Can afford to help more people. +2

Services