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Pharmacy inspections

Inspection reports and learning from inspections

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Innovative dementia support services

Pharmacy type

Community

Pharmacy context

​This was a community pharmacy on a main road in a suburb of a city serving a local population including some elderly and professional families, dispensing around 5000 NHS items per month. The NHS items included supply to around 70 patients in MDS trays. Other NHS services provided were the Chronic Medication Service (CMS), Minor Ailments Service (eMAS), smoking cessation, the gluten free food prescribing service and the local palliative care service, including on-call duties. Services provided under Patient Group Directions (PGDs) were unscheduled care, emergency hormonal contraception, chloramphenicol ophthalmic products, post-immunisation paracetamol and chlamydia treatment.  Other services included a travel clinic, health check service, flu vaccinations, weight loss service, alcohol and drug testing, reflexology and hearing checks. Additionally both pharmacists ran asthma/Chronic Obstructive Pulmonary Disorder (COPD) clinics from GP surgeries.

Relevant standards

  • 4.1 - The pharmacy services provided are accessible to patients and the public
  • 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

A range of extended services for people with dementia and their families is aligned to patients' needs and expectations and ensuring patient safety and effective care across all services.

How the pharmacy did this

There were a large number of patients in the community suffering from dementia of varying degrees so a need was identified for improved staff and patient/carer knowledge. A regular patient increasingly forgot where she stayed resulting in a member of staff taking her home. This demonstrated that there was a clear need for some local provision for dementia sufferers which prompted one of the pharmacists to undertake personal training and development and become involved with other healthcare professionals, including specialists, on a dementia project. This pharmacist developed a checklist of topics to be considered in pharmacies to make them 'dementia friendly', initially for use in this pharmacy, but believing that this could be useful for other pharmacies, she encouraged a summer placement student to develop this into a toolkit for use in all pharmacies. This included training material for pharmacy staff, agencies to signpost patients to, and an audit to undertake in the pharmacy to assess its 'dementia friendliness'. The toolkit had been shared with the Royal Pharmaceutical Society as a resource and it was being distributed at events on dementia over the following months. It was also being used by a University and trialled in some local pharmacies there. A link had been made with Alzheimer's Scotland and all staff in the pharmacy had been trained by one of their outreach workers, and a clinic set up in the pharmacy. This had been a weekly drop-in type session for patients, carers and families to access support and signposting. It was well attended and popular, so had grown too big for the pharmacy and was now run from a local Church hall. A couple had been signposted to this group and benefited by the dementia sufferer being taken shopping and then supported to cook a nutritious meal in her own house, something she had previously enjoyed doing. This gave her husband some respite from caring for her.

Local businesses signposted their customers to the pharmacy, and this had resulted in the pharmacist delivering training to businesses. The pharmacist regularly worked on a dementia garden with other healthcare professionals and was involved with local fundraising for the condition. The pharmacy won an award for the Best Independent Community Pharmacy for Innovation for the work in the area of dementia. An example was described of preventing a hospital admission by recognising that a dementia sufferer's acute confusion that had manifested overnight, was probably caused by an infection. The pharmacist contacted the out of hours medical service and arranged a prescription for antibiotics and nursing care in the patient's home, while explaining the likely cause of the symptoms to the patient's daughter.

What difference this made to patients

Patients with dementia and their families receive much needed support in managing the condition improving quality of life for all affected.

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