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Pharmacy inspections

Inspection reports and learning from inspections

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Collaborative working with other health services to provide access to Buvidal treatment

Pharmacy type


Pharmacy context

Thepharmacy dispenses NHS prescriptions including supplying medicines inmulti-compartment compliance packs. It provides substance misuse services anddispenses private prescriptions. Pharmacy​ team members advise on minorailments and medicines use. And they supply over-the-counter medicines andprescription only medicines via patient group directions (PGDs).

Relevant standards

  • 1.1 - The risks associated with providing pharmacy services are identified and managed
  • 1.2 - The safety and quality of pharmacy services are regularly reviewed and monitored
  • 2.2 - Staff have the appropriate skills, qualifications and competence for their role and the tasks they carry out, or are working under the supervision of another person while they are in training
  • 4.2 - Pharmacy services are managed and delivered safely and effectively
  • 4.3 - Medicines and medical devices are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorized access; supplied to the patient safely; and disposed of safely and securely

Why this is notable practice

The pharmacy is working collaboratively with the local ‘Community Addiction Team’ CAT to provide continual access to Buvidal treatment, especially at short notice. The pharmacy communicates regularly with its wholesaler. This supports cost effective treatment and continuous access to the medicine. The pharmacy provides support and guidance to CATs, enabling them to strengthen governance arrangements associated with managing a Buvidal treatment service. And it identifies and manages the risks associated with the supply of Buvidal.

How the pharmacy did this

The pharmacy had an arrangement with a local CAT which saw it dispense prescriptions for people visiting the CAT for their weekly or monthly Buvidal injection. The CAT emailed the pharmacy a list of people’s prescription requirements in advance of its twice-weekly clinics. This allowed the pharmacy to order stock in good time. The CAT then sent the original prescriptions to the pharmacy ahead of the supply being required.

Pharmacy team members planned workload associated with the service. And they completed this on a quieter day of the week to help manage risks associated with dispensing higher risk medicines. This included checking against the list to manage the risk of missing prescriptions. The CAT collected the assembled Buvidal weekly on an agreed day. The pharmacy also produced a list of supplies to help the CAT check and maintain their own records. Due to the success of the service, the pharmacy went on to set a second service up supplying Buvidal to a ‘complex needs addiction service’ (CNAS). And it managed this in a similar way. It had set up a fully auditable delivery service to the CNAS. This meant that nursing staff did not need to leave the CNAS to collect the medicine.

The superintendent pharmacist conducted a risk assessment before introducing the service. The high prescription volume meant increased storage needs. And they arranged to have an extra controlled drug cabinet installed in the pharmacy. Pharmacy team members involved in delivering the service followed a bespoke standard operating procedure (SOP). This supported them in working safely and consistently when dispensing Buvidal.

What difference this made to patients

Services are managed in an integrated way. This improves outcomes for people accessing substance misuse services. They receive their medicine when they need it, to support their ongoing treatment.

Highlighted standards

We have identified the standards most likely and least likely to be met in inspections, and highlighted examples of notable practice for each of these standards; to help everyone learn from others and to support continuous improvement:

  1. 1.1 Risk management
  2. 1.2 Reviewing and monitoring the safety of services
  3. 4.2 Safe and effective service delivery
  4. 4.3 Sourcing and safe, secure management of medicines and devices
  5. 2.2 Staff skills and qualifications