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Pharmacy inspections

Inspection reports and learning from inspections

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Home delivery services

Pharmacy type

Hospital

Pharmacy context

The pharmacy is located within a hospital. It has 2 main functions; outpatient dispensing for clinics run at the hospital and supply of medication to patients with long term conditions; usually delivered directly to the patient. Both are provided in accordance with a Service Level Agreement (SLA) with the Trust. The pharmacy is open Monday to Friday 9.00am – 1.15pm and 2.00pm - 5.00pm. The pharmacy dispenses about 1,500 items each month and home deliveries are made by a separate company.

Relevant standards

  • 1.1 - The risks associated with providing pharmacy services are identified and managed
  • 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

There are good arrangements in place to ensure medicines and medical devices are supplied to patients safely by the delivery service.

How the pharmacy did this

The pharmacy provided home delivery services to patients from 4 clinical areas within the hospital (oral system anti-cancer drugs, Multiple Sclerosis, Hepatitis C and anti-retroviral). The prescriptions were sent by fax from the prescriber to the pharmacy and screened by the pharmacist. Chemotherapy prescriptions were screened on the ward by a specialist oncology pharmacist. The prescriptions were dispensed, clinically and accuracy checked, the original prescription was checked against the faxed prescription for any errors and then delivered to the patient. Each patient was ‘signed up’ for the service on the ward and had a file containing their information, contact numbers, preferred delivery address, the names of any other people that were authorised to sign for their delivery and their consent. Delivery drivers telephoned the patient to check they were at home and made the delivery 15 minutes later. Once the driver had successfully made the delivery they telephoned the pharmacy to confirm the delivery had been made so that the pharmacist could contact the patient to provide any counselling required. These stages were all recorded on the delivery paperwork.

What difference this made to patients

Confirming in advance that a vulnerable patient is at home to receive a delivery of their medication reduces the risk of them missing their delivery. The delivery driver notifying the pharmacist of successful delivery enables any required counselling with these vulnerable patients to take place in a timely manner, by phone.

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