Pharmacy Law and Clinical Governance

Question 1

Essential services- provided by all contractors

Answer 1

Dispensing medicines
Dispensing appliances
Repeat dispensing
Disposal of medicines
Promotion of healthy lifestyles
Sign posting
Support for self care

Question 2

Wales: Advanced services- can be provided by all contractors once accreditation/competence requirements have been met

Answer 2

MURs- annual review, prescription intervention service
Appliance Use Review
Stoma Customisation service
Discharge medication review

Question 3

England: Advanced services- can be provided by all contractors once accreditation/competence requirements have been met

Answer 3

MURs- annual review, prescription intervention service
Appliance Use Review
Stoma customisation service
New medication service
Flu vaccinations

Question 4

Scotland: Advanced services- can be provided by all contractors once accreditation/competence requirements have been met

Answer 4

Minor Ailment Scheme
Chronic medication service
Acute medication service
National PGD for the urgent supply of repeat medicines and appliances

Question 5

Enhanced services- commissioned locally by Primary Care Organisations in response to the needs of the local population

Answer 5

E.g. supervised administration, needle and syringe exchange, on demand availability of specialist drugs, stop smoking, care home, medicines assessment and compliance support, medication review, minor ailment service, out of hours, supplementary prescribing by pharmacists, EHC, seasonal flu jab, PGDs, chlamydia screening and treatment, NHS health check

Question 6

Dispensing medicines

Answer 6

Pharmacies are required to maintain a record of all medicines dispensed, and also keep records of any interventions made which they judge to be significant. Electronic Prescription Service is also being implemented as part of the dispensing service.

Question 7

Dispensing appliances

Answer 7

Pharmacists may regularly dispense appliances in the course of their business, or they may dispense such prescriptions infrequently, or they may have taken a decision not to dispense them at all. Whilst the terms of service requires a pharmacist to dispense any no-blacklisted medicine with reasonable promptness, for appliances the obligation to dispense only arises if the pharmacist supplies such products in the normal course of business.

Question 8

Repeat dispensing

Answer 8

An official NHS repeat dispensing scheme using FP/WP10 RA- repeat authorisation forms- not a repeat ordering service as run by most community pharmacies. Pharmacies will dispense repeat prescriptions and ensure that each repeat supply is required and seek to ascertain that there is no reason why the patient should be referred back to their GP.

Question 9

Disposal of medicines

Answer 9

Pharmacies are obliged to accept back unwanted medicines from patients, including sharps

Question 10

Promotion of healthy lifestyles

Answer 10

Pharmacies are required to participate in six campaigns every year at the request of the PCO. This involves the display and distribution of leaflets provided. Pharmacy needs to record advice given to patients. In addition, pharmacies are required to undertake prescription linked interventions on major ares of public health concern, such as smoking cessation

Question 11

Signposting

Answer 11

Pharmacies will be expected to help people who ask for assistance by directing them to the most appropriate source of help. Some LHBs will provide the information, others expect you to find it yourself. Records to be kept of referrals- evidence used as part of contract monitoring

Question 12

Support for self care

Answer 12

Pharmacies will help manage minor ailments ad common conditions, by the provision of advice and where appropriate, the sale of medicines, including dealing with referrals from other healthcare providers e.g. 111. Records will be kept where the pharmacist considers it relevant to the care of the patient.

Question 13

New Medicine Service (England only)

Answer 13

Supporting people who have a new medication to manage a long term condition.
Eligible conditions: asthma, COPD, type 2 diabetes, antiplatelet/anticoagulant therapy, hypertension

Question 14

Discharge Medicines Review (Wales only)

Answer 14

Supporting patients who have recently been discharged from a care setting into community

Question 15

Clinical governance and practice of pharmacy

Answer 15

Clinical governance includes recognition and maintenance of good practice, learning from mistakes and improving quality of services provided to patients.
It ensures the service provided to patients is safe, effective and of high quality.

Question 16

Standard Operating Procedures

Answer 16

A SOP specifies in writing what should be done when, where and by whom
Reflect best practice
Reviewed and updated regularly
GPhC standards require SOPs to be in place which must be followed at all times

Question 17

Benefits of SOPs

Answer 17

Maintain quality and consistency
Ensure consistency of good practice
Utilization of all members of pharmacy team
Enable delegation of tasks
Clarification of pharmacy job roles
Advice and guidance for locums/part timers
Useful tool for training new members of staff
Contribute to audit process