A Love-Cake Travel Affair

Time flies. I’ve already one week of rotations down and only 3 more to go. My first rotation happened to be at Pulteney Pharmacy, an independent pharmacy owned by a medical practice. 

The medical practice is located in a historic Georgian town house, and Pulteney Pharmacy gets the privilege of being in the basement. You can see the pharmacy sign peeking out from behind the bicycle in the photo. I soon got used to just seeing the feet of people walking by on the street above as I worked. 

Since the basement wasn’t exactly designed to be a pharmacy, the shelves that hold the drugs are not floorlength but above the countertops, proving to be a difficulty for vertically challenged people like me. Luckily, there’s stools everywhere in the pharmacy but filling prescriptions is like doing a step workout and playing a game of Jenga, trying to grab the right drugs without knocking down the other precariously balanced ones ):

Community pharmacy here in the UK is very different from that in the US, and that’s mostly due to the NHS which everyone here seems to have an opinion about. I won’t bore you with all the nitty gritty details but here’s some of the interesting things I noted: 

Most prescriptions are through the NHS and typed onto light green slips of paper. The current prescription charge is £7.65 per medication. If the patient qualifies for any exemption (such as being over the age of 60, under the age of 16, has a valid medical exemption certificate, valid maternity exemption certificate, participates in an income assistance program, etc.), then they get their medications free. One patient with Celiac’s disease got all of his gluten-free bread rolls, pizza dough, shortbread biscuits, wafers for free since they were prescribed through his GP. Pretty crazy!

The NHS has these cool “quit smoking kits” that pharmacies can hand out to patients. It’s all for free & includes this twisty blue thing for recently quit smokers to fiddle with and distract them from cigarettes. Prescribed hormonal contraceptives are also free, and the NHS has a service in Bath that provides women who qualify with a free condom supply, free emergency contraception, and free chlamydia screening. 

Filling prescriptions is a lot easier since you don’t have to deal with third party claims and the medications come in blister packs so no counting is involved! Instead of the standard 30-day supply we use in the US, most of the medications were in packs of 28. If any medication came in bulk bottles, the dispensaries used a triangular counting tray that lined the tablets up in a pyramid for easy counting.

I had the chance to shadow a general practitioner during his regular surgeries, which apparently means regular “consultations” here in the UK. None of that nip/tuck operation stuff. The healthcare system is set up like a hub and spoke model so that GPs are like the gatekeepers that screen patients before they can be seen by specialists. A regular physician appointment may require 4 weeks in advance to book and last for only 10 minutes. In the UK, all GPs go on home visits for patients who are unable to make it to the office. Here, the GPs go during their lunch hours so I tagged along. Pretty cool stuff!

The awesome part about having a pharmacy that’s part of a medical practice is the lunches! Since the physicians take a lunch break, the pharmacy also closes for 1 hour and 15 minutes. My lunchtimes usually consisted of grabbing a bite to eat from the City Centre (only 5 minutes away), doing some shopping, and exploring. One thing I’ve learned about Bath is that there’s a lot of beautiful sights, just waiting to be discovered. During one lunchtime excursion, I found Henrietta Park tucked behind the street where the pharmacy was located all by chance. Perfect place for enjoying a sandwich (:

I also learned a couple cultural things here:

A floater pharmacist is called a “locum pharmacist” here in the UK. I made the mistake of saying “floater”, only to learn that “floater” is slang for something unpleasant involving a toilet…

The first day I was here, I overheard part of a conversation between the pharmacist and dispensary about something with an expiration date that had come up and whether it was safe since it smelled okay. Being the pharmacy nerd I am, I thought they were referring to some drug, only to learn that they were talking about…the milk. Throughout the week, I learned just how important milk was since caffeine is a person’s next best friend here in the UK. Every morning, the British have coffee/tea, and then in the afternoon, they all have tea again. It makes for a highly caffeine-fueled workday!