Professional guidance 1- concerns Flashcards
Raising concerns
You must take action to protect the well-being of patients and the public
You must be prepared to challenge the judgement of your colleagues and other professionals if you have reason to believe that their decisions could affect the safety or care of others
You must make the relevant authority aware of any policies, systems, working conditions, or the actions, professional performance, or health of others if they may affect patient care or public safety. If something goes wrong or if someone reports a concern to you, make sure that you deal with it appropriately
How can raising concerns effect patients?
Remember that:
your professional duties come before any other loyalties or considerations
failing to raise concerns could result in harm to patients
if you do not report any genuine concerns about a colleague or others it would be a breach of the Standards for Pharmacy Professionals
law relating to raising concerns
Public Interest Disclosure Act 1998 (PIDA) – protects employees (to varying degrees) who raise genuine concerns and expose ‘malpractice’ in the workplace from unfair treatment or victimisation from their employer
Does not cover those who are genuinely self-employed (or students and volunteers)
Allows victims to seek compensation
It sets out a step-by-step approach to raising and escalating your concerns
what is whistleblowing disclosure?
All prescribed bodies legally have to publish an annual report on the whistleblowing disclosures made to them by workers
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How to raise a genuine concern?
Report promptly
Report to your immediate supervisor/
Report to another suitable person in authority or an outside body
- may be some situations when not possible to raise your concerns with your line manager
then may need to speak to freedom to speak up guardian, chief pharmacist, pharmacy owner or superintendent, primary care organisation, profession regulator, CQC
Keep a record
Maintain confidentiality and not disclose information without consent, where possible
What is the freedom to speak up guardian?
Each NHS primary care provider should name an individual who is independent of the line management chain and is not the direct employer as the Freedom to Speak Up Guardian
Could be a member of local CCG, a professional network, local hospital trust Guardian, superintendent pharmacist
Given special responsibility and training in dealing with whistleblowing concerns, and providing support and feedback
Ensure that policies are in place and that staff know who to contact if they have a concern
dos and don’t for genuine concerns?
DO:
Understand that it is alright to speak up, even if you might be mistaken
Read the whistleblowing policy at your organisation, which should name the person that you can go to with your concerns
Stick to the facts and report only what you have witnessed
DON’T
Try to gather evidence yourself
Make allegations
Confuse a genuine concern with a personal grievance
where can you go for more advice?
Where to go for more advice
Public Concern at Work (PCaW) – independent charity that gives free confidential legal advice to people who are not sure whether or how to raise concerns about malpractice at work
Senior members of staff
Professional indemnity insurance provider
GPhC
Freedom to Speak Up Guardian
The charity Pharmacist Support, Your union…
why does complaints arise?
Human error
System failure (e.g inadequate SOPs)
How the complaint is initially handled in the pharmacy
dealing with a complaint
Have an effective complaints procedure in place
Record the complaint
Record the action taken
Review your records regularly
Audit the records regularly
What are the usual types of errors?
how to minimise the risks of dispensing
1) Dispensary Layout
- Organised
- Good atmosphere
- Stock alerts/competent staff
- Segregated dispensing/checking areas
- Effective segregation of prescriptions - (baskets/trays)
2) Dispensing Process
-Label before selecting product from shelf
-Refer to Rx when selecting stock, not the label/PMR
-Dispense from Rx, not the label
-Check boxes to identify involvement
-Two people involved in process, if possible
-If working alone, mental break
-All checks against Rx
-Dispense owings vs Rx, not label or PMR
in the event of an error what needs to be considered?
Consider:
- Has patient taken incorrect medicine(s)? If they have establish degree of harm and contact GP or refer to hospital
- Ask to inspect the incorrect medicine. Make it clear you don’t want to keep it but just inspect it. If they say no, ask them to keep hold of it until they can hand it over to a representative of GPhC or local PCO
- Apologise
- Do not minimise seriousness of error
- Supply correct medicine, if appropriate
-Establish expectations. What would they like you to do about their complaint?
- Provide details of ‘official bodies’ if requested
- Establish what went wrong (root cause analysis)
- Report complaints as per SOPs
- Record, review, learn and take action
- Notify the pharmacist on duty at time of error, if it wasn’t you
- Inform your insurance provider if it was you
how to review errors
Keep a written record of findings
Use CHAPS
Conditions in pharmacy at the time (breaks? how busy was the pharmacy? layout?)
Health of the pharmacist/team
Assistance (was pharmacist working alone? competence of the assistant?)
Prescription recovered (legibility, check endorsements)
Systems used for dispensing/checking reviewed
Near miss logs
FINAL CHECK
HELP!
How much has been dispensed (correct quantity? correct PIL?)
Expiry date check
Label check (same as prescription? appropriate or correct warnings?)
Product check (correct medication and strength as requested on prescription?)
The Pharmacy (Preparation and Dispensing Errors – Hospitaland other Pharmacy Services) Order 2022
Defence for hospital pharmacies provided that certain conditions are met, including a requirement that the hospital has a chief pharmacist whose role will be analogous to that of a superintendent pharmacist in a community pharmacy owned by a body corporate
how to hand out completed prescriptions?
Trained staff
Additional checks (patients address/DOB)
