Nobody made a mistake in Wilhelmina Ross’s case, which is exactly what makes it worth writing about.
The pharmacist has prescribing rights in this service, which removes a referral step that used to add three weeks to every change.
Reviews are booked annually and attended jointly with whoever manages the person’s medicines at home, which is frequently not the person themselves.
Two right answers can add up to a wrong list. Nobody owns the list, so nobody checks it.
Illustrative composite
The call happens at day three and lasts as long as it needs to. The median is nineteen minutes; the longest recorded on this service is fifty-two.
One in six of this service’s discharge calls finds something similar. “It isn’t rare,” says her pharmacist. “It’s just invisible.”
