Your Medicals (9012314) - Improvement action plan

In the previous inspection the pharmacy had been advised to complete an audit of the prescribing decisions of the pharmacist independent prescriber (PIP) who had recently started prescribing at the pharmacy. The pharmacy has now employed a second PIP and has not completed an audit of either PIP's prescribing decisions. This makes it difficult for the pharmacy to demonstrate that its written processes are followed and continue to be effective.

An audit will be completed imminently once this has been approved. The superintendent has made changes to how the prescribers operates and weight is independently verified by video. Prescribers are told to make independent notes per order, and this will be reviewed as part of the audit process.

The main activity of the pharmacy is a private online weight management service. The pharmacy has not fully considered the risks of how external factors may impact this service. Or put in place effective processes to mitigate these factors and ensure that its patients receive appropriate ongoing support and continuity of care.

The pharmacy has recognised that its main service the private online weight management programme represents a significant part of its operations. To address the risks associated with this dependency and ensure patients continue to receive safe, effective, and uninterrupted care, the pharmacy has taken the following actions:

1. Comprehensive Risk Assessment:
A full risk assessment has been completed to identify external and internal factors that could impact the weight management service. These include medicine supply shortages, prescriber availability, regulatory changes, and patient demand fluctuations.
2. Service Dependency Review:
The pharmacy has formally included “service dependency” in its risk register to monitor and manage the risk of relying on a single service for the majority of business activity.
3. Contingency Planning:
Plans have been established to ensure continuity of care if the service is disrupted. These include secondary prescribing partners, backup stock suppliers, and clear patient communication procedures for treatment continuity.
4. Service Diversification:
Work has begun to broaden the range of private clinical services offered to reduce dependency on one core service.
5. Ongoing Monitoring:
The Superintendent Pharmacist reviews service performance and external risk factors monthly. Any identified issues are discussed at governance meetings, and updates are made to the risk log and mitigation plans accordingly.
6. Staff Awareness and Training:
Staff have been briefed on the updated risk management framework and trained to identify early warning signs that could affect continuity of patient care such as stock shortage.

When accessing a service patients provide initial information through an online questionnaire. The questionnaires cover key areas such as medical history and risk factors. But if a patient gives an answer that means that the medicine cannot be supplied this is flagged to them. The patient could then change the answer, and the system does not flag this up to the prescriber. This may mean that a prescriber does not have all the information they need to make a safe prescribing decision. This issue was raised at the previous inspection and the process has not been changed.

This has now been changed. Once the answer has been changed, the pharmacy team will be notified at the bottom of the questionnaire that the answer was changed. The pharmacy team can then contact the customer to verify or access their SCR to confirm certain details.