Derix Healthcare Pharmacy (1092675) - Improvement action plan

The pharmacy does not sufficiently monitor the safety and quality of the various elements of its prescribing service. For example, by undertaking regular clinical audits.

We will implement a system to monitor safety and quality of our prescribing service. This will include regular clinical audits and reviews of prescribing patterns to ensure adherence to best practices. These audits will be completed once a year, against GPhC standards with the guidance from RPS and NICE.

In order to aim to enhance the quality, safety, and effectiveness of patient care, the elements we are looking to audit:

Prescription Accuracy and Appropriateness: Ensuring prescriptions are correctly written and appropriate for the patient's condition, including checks for dosages, duration, and medication choice according to current guidelines.

Clinical Effectiveness: We will assess whether the prescribed medications are effective for the intended clinical condition, based on the latest evidence and guidelines.

Patient Safety: we will identify and minimise risks related to medication errors, interactions and adverse effects. This includes monitoring for potential allergic reactions and ensuring that the medication is safe for the patient's specific health status.

Adherence to Guidelines: We will verify that prescribing practices adhere to national and local guidelines, such as those provided by NICE, and any relevant formulary restrictions.

Patient Experience and Engagement: We will assess how effectively patients are engaged in their treatment decisions, including the provision of information about their medications, potential side effects, and the importance of adherence to prescribed treatments.

Record Keeping and Documentation: We will review the quality and completeness of prescription records and clinical notes, ensuring they meet legal and professional standards for documentation.

Multidisciplinary Collaboration: We will assess the effectiveness of communication and collaboration between pharmacists, doctors, and other healthcare professionals involved in the prescribing process.

Additional audits may be required in response to specific issues, changes in practice, or the introduction of new guidelines or medications.

The pharmacy cannot sufficiently demonstrate that all its prescribers have the appropriate training and competence for the services they provide.

Will implement a training and competency assessment programme with regular updates and continuing education related to prescribing.

We will achieve this by producing a spreadsheet with every member of staff training log which will include- their name, training completed including PQS required training in relation to prescribing. Even if the member of staff is not a prescribing pharmacist, there will be courses they need to undertake in order to have the necessary knowledge to stay updated with the latest rules and regulations. i.e, mandatory training and or reading and understanding of mandatory policies such as safeguarding, data protection and confidentiality.

The spreadsheet for prescribing pharmacists will be separate as their list of courses and training to complete will be significantly different to regular members of staff.

The pharmacy cannot demonstrate that its prescribing service is safe. For example, the pharmacy's prescriber does not make the appropriate records to show that medicines are only supplied when clinically appropriate. The pharmacy doesn't routinely seek consent to share information with other healthcare providers or share details about what has been prescribed with people's regular prescribers when it has consent to do so. It does not monitor the safety and quality of its prescribing service. The pharmacy cannot sufficiently demonstrate that it provides its vitamin B12 injection service in accordance with legal requirements.

Will develop a process in order to demonstrate safety of our prescribing service by creating protocols for prescribing, ensuring informed consent is obtained for sharing information with other healthcare providers and keeping detailed records of all the prescriptions issued especially when they deviate from what regular prescribers have provided. We will demonstrate that we provide our vitamin B12 service in accordance with legal requirements. Records will be kept (electronic records included) to show adherence to law.

The "protocols for prescribing" we will be developing and implementing are aiming to ensure that the prescribing service is safe, effective, and patient-centred. These protocols will ensure we are safeguarding patient welfare and ensuring high standards of care. These protocols and how they will help demonstrate the the prescribing service will be safe are as follows:

Clinical Governance and Audit: Clinical governance will ensure that we provide high-quality health services and continuously improve them. Regular audits of prescribing practices will help to identify areas for improvement and ensure compliance with the latest guidelines and regulations.

SOPs: Use of SOPs will provide a clear, step-by-step guide for pharmacists on how to manage the prescribing process, from assessing the patient's needs to the final dispensing of medication.

Training and Competency: Pharmacists involved in prescribing must complete additional training and demonstrate their competence. This will ensure they have the necessary skills and knowledge to prescribe safely, including an understanding of the legal and ethical aspects of prescribing.

Patient Consent and Confidentiality: We will ensure that patient consent is obtained before prescribing, ensuring patients are fully informed about their treatment options. Maintaining patient confidentiality is paramount, with strict guidelines on how patient information is stored and shared. This will also contribute to demonstrate that the prescribing service will be safe.

Clinical Decision Support Guidelines: Using national guidelines such as NICE will ensure that prescribing practices are evidence-based, promoting high-quality patient care, and enhancing patient safety. These guidelines provide us with up-to-date recommendations on the most effective treatments and medicines, reducing variability in practice and helping to standardize care across different settings.

Collaboration with Other Healthcare Professionals: Effective communication and collaboration with GPs, nurses, and other healthcare professionals are crucial for safe prescribing. We will stay in constant communication with patients healthcare providers in order to maintain a safe prescribing service.

Reporting and Learning from Errors: we will be encouraging a culture of reporting and learning from prescribing errors or near misses which is vital for improving safety. We are setting up mechanisms for reporting these incidents, analysing them, and implementing lessons learned to prevent future errors.

Regulatory Compliance: We will comply with regulations from bodies such as the GPhC and the MHRA. These regulations set out the legal requirements for safe prescribing and dispensing.

Patient Information and Support: Providing patients with clear information about their medications, including how to take them safely and what side effects to look out for, is an integral part of the prescribing process and something we will be implementing. Support may also include signposting to additional services or support groups which will also contribute to a safe prescribing service.