Hollowood Chemists Ltd (1033127) - Improvement action plan

The pharmacy does not keep the responsible pharmacist (RP) register fully complete and accurate. Required entries are missing from the RP record, which means the pharmacy cannot provide an accurate audit trail of responsible pharmacist activity and compliance with legal requirements.

Following identification of the incomplete Responsible Pharmacist (RP) records during the GPhC inspection, the pharmacy has taken immediate action to investigate the omissions, address the deficiencies and strengthen its governance arrangements. 1. Immediate investigation and corrective action • The Superintendent Pharmacist was informed of the findings on the day of inspection and immediately contacted the pharmacist concerned to discuss the omissions and reinforce the legal requirements for maintaining accurate RP records. • A review of the incomplete RP entries was initiated, supported by contemporaneous evidence including staff rotas, clinical checking records and other documented professional activities. • The RP notice was confirmed to have been displayed during the relevant period. • Retrospective corrections to the RP record have been made with all late entries clearly identified and dated to preserve an accurate audit trail. No entries will be backdated or presented as contemporaneous records. • The omissions have been addressed directly with the pharmacist concerned, who has acknowledged the importance of maintaining complete and accurate records. 2. Review of procedures and staff responsibilities • The RP Standard Operating Procedure (SOP) has been reviewed with the pharmacist concerned, reinforcing the requirement to record the commencement and cessation of RP responsibility accurately on every occasion. • All pharmacists working at the premises will be reminded of their individual legal responsibilities for maintaining the RP record including leaving a notice for locum pharmacists • Completion of the RP record will be incorporated into the pharmacy’s daily opening and closing procedures, with pharmacists required to verify that the appropriate entries have been made. 3. Enhanced monitoring and governance • The RP record will be checked daily by the pharmacist • Weekly RP record compliance checks will be introduced initially to identify and address any omissions promptly. The report from this will be provided to all pharmacies and will be presented in the company weekly Tuesday meeting to ensure 100% compliance at all times. • Following a sustained period of full compliance, monitoring will transition to monthly reviews to ensure continued adherence. • Any discrepancies identified will be escalated promptly to the Superintendent Pharmacist for investigation and corrective action. • Monitoring outcomes and actions taken will be documented to provide an auditable record of ongoing compliance. 4. Wider assurance and continuous improvement • The effectiveness of the revised procedures and monitoring arrangements will be reviewed regularly to ensure sustained compliance with Standard 1.6 and the relevant legal requirements. The pharmacy acknowledges the seriousness of the omissions and is committed to maintaining complete, accurate and contemporaneous RP records. The immediate investigation, SOP review, strengthened daily procedures and enhanced monitoring arrangements are intended to prevent recurrence and provide assurance of sustained compliance.