POMs 2

Question 1

What are the 2 proposed models for Hubs and Spokes? (2)

Answer 1

Rx handed in at spoke, sent to hub, hub sends meds to spoke, spoke supplies pt.

Rx handed in at spoke, sent to hub, hub supplies patient (via post or delivery).

Question 2

What are the advantages of dispensing from a Hub? (4)

Answer 2

Better efficiency
Lower operating costs
Frees up pharmacist time.
Use of automation in the hub.

Question 3

What are the disadvantages of dispensing from a hub? (5)

Answer 3

Accountability and liability.
Confidentiality and information security.
Clinical/Accuracy Check
Operational Failure
Unsuitable for quick medicine supply.

Question 4

What are internet pharmacies? (1)

Answer 4

Distance-selling pharmacies.

Question 5

What are the risks associated with using internet pharmacies? (3)

Answer 5

High-risk medicine prescribing e.g. habit-forming medicines, liable to misuse medicines e.g. CDs, Z drugs, weight loss medicines or medicines which require monitoring, with no adequate safeguards put in place.

Prescribing medicines out of Rxer’s competence.

High volumes of Rx issued in short time.

Question 6

Give e.g. of poor practice identified by GPhC regarding internet pharmacies. (5)

Answer 6

Prescribing decisions made in transactional way rather than checking with GP.

Lacking real time or face to face consultation.

Commercial > Clinical focus

Poor or weak checking and monitoring of multiple or repeat supplies.

History and symptoms of patients are taken at face value.

Question 7

What are the main features of SSP? (8)

Answer 7

Serious Shortage Protocols:
- Only used if legal Rx is presented.

• Patient consent required. If not prescriber refer is sought.
• Pharmacist must ensure patient understands the difference between prescribed drug and alternative.
• The dispensing label needs to indicate that a supply was made under the SSP and states the reference number of the SSP. There’s a permanent record in the patient’s PMR.
• Px who usually pay a Rx charge but receive a smaller quantity are exempt from a Rx charge payment.
• Once a supply is made under the SSP, the original Rx is no longer valid and no further supply can be dispensed from it.
• Each SSP is time-limited i.e. has an expiry date which can be extended if the medicine is in short supply e.g. Fluoxetine, Haloperidol, drugs used for epilepsy, HRT.

Question 8

What are the main features of PCU? (8)

Answer 8

Prescription Collection Units:
- Automated Rx collection machine and lockers.

• Medicine collection is allowed at anytime, 24 hrs a day on an any day of the week even when pharmacy is closed and no pharmacist is on the premises.
• Px consent is required.
• Unsuitable for fridge items, CDs requiring safe custody, bulky items.
• Px accessed by using a password or secure code.

Clear audit trail is available.

Storage space = limited.

Question 9

What are the main features of POM administration? (5)

Answer 9

Unlawful to administer a parenteral POM other than to yourself unless you are an appropriate practitioner or acting under the directions of an appropriate practitioner.

Exemptions:
For purpose of saving one’s life:
- Injectables e.g. Small pox, adrenaline, glucagon.
HCP:
- Midwives
- Paramedics

No legal restrictions on non-parenteral POM

Question 10

What are the main features of administering POMs in hospitals and other settings? (4)

Answer 10

PSD’s are written on inpatient charts as directions to administer.

Then are copied onto an order form for the pharmacy to prepare discharge.

The pharmacist carries out or checks that the process is correctly executed.

Order form doesn’t replace a discharge letter.