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.
- 2.1 - There are enough staff, suitably qualified and skilled, for the safe and effective provision of the pharmacy services provided
- 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
- 2.3 - Staff can comply with their own professional and legal obligations and are empowered to exercise their professional judgement in the best interests of patients and the public
- 2.4 - There is a culture of openness, honesty and learning
- 2.5 - Staff are empowered to provide feedback and raise concerns about meeting these standards and other aspects of pharmacy services
Why this is notable practice
There is a strong emphasis on training (including extended technician training), development and communication to ensure that highly qualified and skilled individuals are utilised to deliver innovative services to benefit the local community.
How the pharmacy did this
Both pharmacists ran asthma/COPD clinics in separate GP practices, and they were both dedicating half a day per week to a polypharmacy project locally, with a view to extending their clinics to move to or include polypharmacy. They were heavily involved in the implementation and planning of these clinics locally and were supported by a peer mentor. This was linked to a requirement of Prescription for Excellence. Staff worked in a variety of shift patterns giving flexibility to cover for absence and planning for staffing during clinic times. There were usually three dispensers working and the ACT sometimes dispensed. The use of the audit trail on prescriptions ensured that the ACT did not check prescriptions that she had already been involved in any part of. A tablet was used to access training modules with each staff member having their own login and records maintained of modules undertaken. Protected time was given for training . The ACT managed this, taking on more responsibility and ownership than is often seen in a technician role. This attribute was being used and developed. Appraisals/development meetings were held annually with six-month interim meetings and documentation in place to support these. Among other topics, there was emphasis and training on certain patient groups to equip technicians to have greater clinical roles. It also focused on medicines reconciliation empowering the technician to undertake more of this, particularly for MDS patients. As part of her training and development the technician had been out with the pharmacist on domiciliary visits assessing patients for suitability for compliance aids. The technician had won a ‘Technician of the Year’ award for her work in largely managing the professional side of the business, being the continuity as both pharmacists were part time. She was recognised for her professionalism and ability to manage staff training to the high level required to complement the additional services in the pharmacy. Weekly meetings and monthly learning sessions and senior staff meetings were held to share information across the pharmacy team. Minutes showed topics covered included MDS processes, SOP compliance and reminders to put dates on owing slips.
What difference this made to patients
Patients are able to benefit from a highly trained and competent staff group that are constantly seeking to improve the services they offer.
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: