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Medicine Management in Retail Pharmacy – A Leadership Vacuum?

Beyond best practice

Attending a recent pharmacy safety conference in Cardiff, I and others were looking for the guiding lights and best practice recommendations on this important subject. Safety and best practice are in no way mutually exclusive.

We all heard a patient story, powerfully delivered by Donna Dunn, of her inspirational daughter who sadly lost her fight to blood cancer. The story contained many heart wrenching aspects about her daughter’s care, but we learned how a Pharmacist obtained and delivered important eye drops mandatory for the daughter to be allowed home.  He liaised with doctors, and delivered them to her door, out of hours, to enable the daughter to spend another precious night at home, before being re-admitted to hospital.

This selfless action of the Pharmacist wasn’t best practice, but it was exceptional, kind and empathetic and removed significant barriers to allow the family to spend valuable time together. It was only a year later the Pharmacist learnt the significance of his actions; it was her last night at home with her family.

Balancing care obligations with commercial pressures

For the Pharmacist of the future to survive, clinical care and patient trust will be paramount, but with ever increasing commercial pressures does that mean safe processes designed to protect the quality of care we expect will skipped in favour of commercial bottom line and profits?

Organisations such as Well Pharmacy are demonstrating strong commercial leadership, investing in the use of technology and automation, and have created a network of pharmacy outlets with a new smart professional look.   

It will be interesting to see how their strategy develops but early signs look positive.

Are the regulators letting down Pharmacists?

The role of the retail pharmacist is very unlike your GP, or NHS Hospital because the pharmacist is often employed by a large corporate. Income is subject to the employer, and often performance-related.  The equipment and facilities are supplied by the retailer, and fittings and storage of refrigerated medicines are all investments and a capital cost. Investment is commercially-lead and affected by the pressures on high street retail today.

However, compliance and safety is placed fairly and squarely on the Pharmacist by the regulators, and not the employer’s responsibility. That’s a difficult balance, and one where advice and guidance would be very welcome.

Best practice and safety are not choices, they are a compulsory requirement laid down in GPhC regulations.  Compliance with these regulations are extremely important to protect standards and practices. So, you would think when it comes to implementing these regulations, GPhC auditors (with all their experience and exposure to Pharmacists up and down the country) could offer advice and guidance?

Sadly that’s not the case, when challenged representatives of the GPhC said…”its not our place to offer guidance or advice, our role is to implement the standards”.  Big stick approach!

Have industry bodies caught up with new pharmacy technologies?

Safety can be now supported with automation and technology.  Technology reduces human error, labour, time and mistakes. Automation reduces errors, saves cost and helps the commercial pressures on the hard-pressed retail pharmacist and provides insights to communicate to his employer. It would seem that the logical step that the professional body in the form of the Royal Pharmaceutical Society (RPS) would supposedly support and provide leadership to their pharmacy members, in order to help them manage the retail pressures placed on them.

Sadly, very little evidence can be found of this. It seems that the RPS will not engage with technology providers, no evaluation programs exist, technology pages on their website are absent, guidance or advice on using non-specific technology to improve compliance missing.

In Europe or the USA a very different scenario emerges.  Pharmacists pay subscriptions as a member of the industry body and receive advice, insights and regular training and education programmes.  So why is so hard for technology to be incorporated into retail pharmacy support in the UK?

Create an embedded safety culture

Creating an embedded safety culture within an organisation is all about people. This culture needs to ensure staff feel safe to report potential risk, without fear of reprisal or impacting on their working environment negatively. Staff need to anticipate and combat risk, learning from mistakes openly and to be empowered to implement changes. An environment of teamwork and processes designed to remove human error. If manually recording the temperature on a medicine fridge once a day holds no value, then its little wonder that it gets missed or not done.

Activity without value risks complacency and increases risk. The correct management of medicines and controlled drugs, such as vaccines and temperatures sensitive drugs as regulated in section 4.3, is the number 1 out of compliance issues as recorded by the GPhC. 

Is this where the PDA can help?  As a union they can support, protect and advise members on best practice; its early days for the PDA but the signs look positive. They are certainly acting in the best interests of their members and challenging big corporates on safety and practices.

Could the PDA be the answer, to fill the current industry leadership vacuum, and supply the guidance so desperately needed?

Case Study – multisite pharmacy temperature monitoring

By implementing a Tutela monitoring system, customers such as  Royal Berkshire NHS Foundation Trust have minimised their risk, protected their material 24/7/365 continuous, uninterrupted hospital refrigerator temperature monitoring in near real-time of temperature-sensitive medicines.  With Royal Berks’ commitment to quality and efficiency, they sought to acquire a pharmacy temperature monitoring system that was capable of providing integrated monitoring of medicines from central Pharmacy through those stored on the ward.  Key objectives were meeting the compliance requirements of MHRA, free up resources and reduce cost..

Staff at Royal Berks use the Tutela web-based interface.  This powerful graphical user interface (GUI) is provided for an unlimited number of staff and is specifically set up by the site administrators to allow users access to their departments and probes.  Refined built-in administrator options ensure that users are allocated the correct permissions. The web interface allows multiple site viewing for central QA reporting, as well as individual local view for system operators

The role of monitoring technology in retail pharmacy

Tutela is the world’s largest independent pharmacy temperature monitoring and data insights platform providing critical process control of temperature sensitive biological inventory and products.

Tutela have supplied 1000’s of systems to the NHS, Biotech and Pharmaceutical industries as well as research facilities such as the APHA (Defra).

Tutela’s technology can remotely monitor every fridge or freezer door, temperature, ambient and humidity. In every room, ward, department, hospital or remote clinic all under one account. Protected, secure with full reporting and action audit trail.

Our goals are simple

With clear leadership and independent monitoring of the Pharmacist is protected, patient trust is strengthened and your corporate owners reputation remains intact. Tutela embed safety into your everyday process to protect your name.

Together, Tutela aim to partner and reduce the risk, protect reputations and support the Pharmacists, who else can say that?

 

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