As the pharmacist, you are a key member of the MDT. Today you are meeting with colleagues to decide what to do about a ‘non-compliant patient’, Arthur Phillips, a retired labourer.
Arthur (58) is a smoker and has had diabetes for about 15 years. This has resulted in complications and damage to his circulation, which was severe enough for him to have had a foot amputated.
He was fortunate that the condition was operable. His prospects are reasonably good if he stops smoking and exercises to improve circulation and lose weight. To prevent further deterioration, it was decided that Arthur would benefit from home visits from a physiotherapist to help implement an exercise plan to improve his circulation.
Arthur agreed to this plan, but after a few visits it’s now clear he’s not even attempting to carry it out. He is also refusing to quit smoking.
Arthur is very keen for the physiotherapist to continue visiting, though it’s not clear why since he is at times confrontational. In the team meeting the physiotherapist explains that when she suggested that home visits could be stopped he was upset and pointed out that he has ‘a right to treatment - it’s in the NHS Constitution’.
There is considerable demand for physiotherapy services locally and some team members are arguing that the cost of treatment for Mr. Phillips cannot be justified.