The Pharmacist Flashcards
What kind of deaths does the HM coroner investigate?
Unnatural or unexpected
Cause of death unknown
In state detention (e.g.prison)
Which deaths are reported to the coroner?
The deceased was not seen by a doctor during their final illness
Death certificate unavailable
The death certificate cannot be signed by the doctor declaring death within 14 days
Occurred during surgery or before emerging from anaesthetic
Occurred from industrial disease or poisoning
Sudden, unexplained, violent or due to neglect, suspicious or occurred in police custody or prison
What is the coroners primary mode of investigation?
The inquest
Who is present at the inquest?
Coroner Interested parties Media General witness Police witness Coroners assistant Family members Expert witnesses
What happens is during an inquest if evidence emerges that a crime has been committed?
Stop the inquest until after criminal proceedings are complete
Does the coroner issue verdicts?
No, issues conclusions: Natural causes Drug dependant Attempted or self-induced abortion Accident or misadventure Disaster subject to public enquiry Self neglect Suicide Unlawful killing Lawful killing Industrial disease Open
What must you do if you get a Rule 43 letter?
Act upon it immediately
Respond in writing
When can a civil litigation (law suit) occur?
After the inquest has concluded
Are coroners courts open to the public?
Yes the public and media can attend
What is the Bolam/Bolitho test?
Standard against which one is judged is that of ones own peers
But cannot defend a case on the basis of a current practice
Why was the responsible pharmacist legislation needed?
So pharmacists could persue a greater clinical role in the pharmacy, in same location adjacent to the pharmacy, elsewhere
How did they bring in the RP legislation?
In a phased approach
1st- RP regulations which set quality framework and was largely mandatory
2nd stage hasnt happened yet but will enable supervision changes so free up pharmacists time
What did the Health Act 2006 change regarding the RP?
Changes to control and supervision
Replaced ‘personal control’ with ‘responsible pharmacist’
Sets out statutory duty of the responsible pharmacist to secure safe and effective running of the pharmacy
Enables ministers to make regulations (the details)
When did the Medicines Regulations (RP) 2008 come into force?
1st October 2009
Which pharmacies have to have a RP?
All pharmacies registered with the GPhC
Who can be the RP?
The person carrying on the business
One of the partners of the business
Another pharmacist
For body corporate - SI/manager or assistant pharmacist subject to directions of SI
How many RP’s can you have?
ONE AT ANY ONE TIME
What must be on the RP notice?
RP name
RP GPhC registration number
That you are in charge of the pharmacy at that time
What must the RP record?
Name and reg number
Date and time they became RP and ceased to be RP
Does the RP record have to be done daily?
No - could be signed on monday and then ceased on friday
What must the RP record about their absence from the pharmacy
Date
Time commenced
Time of return
Reason not a legal requirement but good practice
How long must the RP record be kept for?
5 years
The RP record is contemporaneous - what does this mean?
You cant fill it in ahead of time
Daily record
Continuous
Can you alter the RP record?
It is like a CD record - must identify who has made alterations
RP are responsible for SOP’s - what do the SOP’s need to cover?
Arrangements to secure meds are ordered, stored, prepared, sold, supplied, delivered and disposed of in safe and effective manner
Giving advice on meds to non-pharmacist staff
Identify pharmacy staff competent to undertake specific activities
Record keeping
Arrangements when RP absent
Steps when RP changes
Complaints procedure
Adverse incident procedure
Notifications of changes to procedures to pharmacy staff
When is the RP responsible?
Only when pharmacy is in operation so in opening hours or while staff are prepping (but pharmacist may come in later than the staff)
How long can the RP be absent from the pharmacy for?
2 hours
If the RP is absent, what must happen?
Remain contactable
Able to return with reasonable promptness
If this not possible, another pharmacist must be available for advice (don need to be on premises)
What is ‘supervision’ (RP)
Not defined so case law in courts
Where required, a transaction cannot take place without physical presence of pharmacist
What can happen when there is an RP supervising and present?
Professional Rx check
Sale/supply of P and POM
Supply PGD
Emergency supply
What can happen when RP supervising but not physically present?
Assembly process
What can happen when RP but not requiring supervision?
GSL sale
Processing waste stock/patient returns EXCEPT CD’s
What is an RP not required for?
Ordering stock from wholesalers Receiving stock Putting away to shelves Date checking (all excluding CD's) Accessing PMR Receiving Rx from patient or surgery Delivery person giving meds to patient
What did the Pharmacy order aim to change?
Establish an independent pharmacy regulator
What are the key principles underpinning statutory professional regulation?
Main interest is safety and quality of care for patients
Impartiality - independent regulator
Sustaining, assuring, improving standards and identifying and addressing poor practice or behavior
Not creating unnecessary burdens
Recognise need for system that ensures strength and integrity of UK health professionals, and is flexible and effective
Until 2010. what was the setup of the Royal Pharmaceutical Society
General Pharmaceutical Council
Royal Pharmaceutical Society
What are the 5 types of RPS membership?
Member (MRPharmS) Fellow (FRPharmS) Associate (ARPharmS) Pharmaceutical Scientist Student
What are the 8 parts of the Pharmacy Order?
1 - Preliminary 2- Council and its committees 3- Registered Pharmacies:standards in retail pharmacies 4 - registration 5- Education, training, acquisition of experience and and CPD 6 - fitness to practice 7 - proceedings 8 - miscellaneous
Who does the GPhC regulate?
Pharmacists
Pharmacy technicians
Pharmacy premises
JUST IN GB
What are the general duties of GPhC?
Protect, promote and maintain the health, safety and well being of the members of the public by ensuring that registrants and those carrying out a retail pharmacy business adhere to such standards
What are the principal functions of the GPhC?
Establish and maintain a register
Set and promote standards
Set reference for fitness to practice
Promote safe and effective practice by registrants
Set standards for education, training, acquisition of experience and CPD necessary
To ensure continued fitness to practice of all registrants
What is the structure of the GPhC? (Who is in it?)
14 members including a chairman (Nigel Clarke)
7 lay members, 7 registrant members
Reserved places for at least one member from each country in GB (lives or works there)
Not elected -appointed by Appointments Committee
Who elects the GPhC registrar and Deputy Registrar?
The council elect the Registrar
The registrar can then authorise a Deputy Registrar or an employee of the Council to act for a Registrar in any matter
What are the five parts of the GPhC register?
1 - Pharmacists
2 - Pharmacy technicians
3 - Premises
4 - Pharmacists who are visiting practitioners
5 - Pharmacy technicians who are visiting practitioners
What are the protected titles under the GPhC?
Pharmacists
Pharmacy technicians
In the Pharmacy order, what is a ‘practising’ pharmacist?
Anyone acting in the capacity who does any work or gives any advice in relation to the preparation, assembly, dispensing, sale, supply or use of meds, science of med, practice of pharmacy or the provision of healthcare
To be on the Register, the registrar has to be satisfied that:
The person is appropriately qualified
Their fitness to practice is not impaired
Meet additional requirements where necessary (relating to education, training, experience)
Prescribed fee has been paid
Which qualifications are recognised as appropriate?
UK Mpharm + pre reg year +GPhC or PSNI exam
EEA qualification - EEA national or not
(if not-OSPAP + 12 month pre reg)
What must you provide the GPhC team with for registration?
Application form Degree/OSPAP certificate copy Birth certificate copy Marriage/ civil parternshio certificate copy Proof of identity copy Tutor final declaration Letter of good standing (OSPAP grads) Payment form Certified photo
Currently, which annotations are available?
Supplementary prescribers
Independent prescribers
How often do you need to renew GPhC registration?
Every year provided fit to practice, meet standards of proficiency and additional requirements (and fee paid)
What are the GPhC pharmacist declarations?
Fit to practice
Health declarations
Intent to practice as a pharmacist in GB and that info in application is complete, true and accurate
What are the GPhC MPharm student declarations?
Standards for pharmacy professionals
Criminal record declaration
What information is on the GPhC register for pharmacists and technicians?
Title, Surname, forename, postal town Annotations (pharmacists) Superintendent (pharmacists) GPhC reg number Fitness to practice issues
What information is on the GPhC register for pharmacy premises?
Trading name Owner Current address Subject to notices or conditions/ Internet pharmacy logo (voluntary) GPhC reg number - if selling online
Who does the GPhC have a requirement to consult?
Registrants
Employers of registrants
Professional bodies or organisations representing registrants
Users of services of registrants
Those commissioning or funding the services provided by registrants or at registered pharmacies
Persons carrying on a retail pharmacy business at a registered pharmacy
Those providing, assessing, regulating or funding education and training for registrants or prospective registrant
Is the GPhC Guidance mandatory?
No, but you should still follow it (should rather than must)
What must the GPhC set in education?
Standards of proficiency for safe and effective practice of pharmacy which it is necessary for a person to achieve in order to be entered in Part 1 or 2 of the Register
Standards that providers of education and training must meet
Any requirements to be satisfied for admission to, and continued participation in, education and training
What does the GPhC accredit?
Courses Qualifications Institutions and other providers (tutors) Premises (Maintain and publish a list)
What was decided regarding English language competency?
Lords Committee report - All health professional regulators should be permitted to ensure the language competency of EEA applicants prior to granting them registration
2015- ALL registrants and applicants have necessary english, order makes provision to introduce language controls for EEA nationals or equivalent
2016 - This law applies to ALL
What powers do the GPhC have in respect of education and training
Determine courses for annotations and fitness to practice
Hold assessments for approved qualifications, additional education, training or experience, tutors
Appoint examiners
Lists or premises that are training establishments
Which qualifications does the GPhC recognise?
MPharm
OSPAP’s year then normal pre reg
Prescribing programmes leading to annotation
Competency and knowledge based leading to technician registration
They have some say in what goes into meds counter assistant courses
What does the EU directive enable?
Once qualified in the UK, can practice anywhere in the EU at the moment
What are the standards for pharmacy professionals?
Professional behaviour Professional judgement Leadership Professional knowledge and skills Patient-centred professionalism Effective communication Partnership working Speaking up about concerns Confidentiality and privacy
What are the three parts of the revalidation framework?
4 CPD records
Peer discussion
Reflective account
What does the peer discussion in the revalidation framework involve?
Speak to someone about their practice and record the benefit it has for the people using their service
GPhC do not ask for details of what was discussed, but may confirm it took place
What does the reflective account in the revalidation framework include?
Write a reflective account based of GPhC standards for pharmacy professionals - to demonstrate reflection is happening
They choose standards each year for pharmacists to think about
What is an impairment of fitness to practice?
Misconducts Deficient professional performance Adverse physical or mental health Failure to comply with a reasonable requirement imposed by assessors in connection with carrying out a professional performance assessment Conviction of a criminal offence Fixed penalty Police caution Determination by a regulatory body for health and social care profession that FtP impaired Including in a barred list
What is covered in the threshold criteria for investigations?
Conduct, performance
Health
Public interest
How does the GPhC deal with concerns?
Concern raised - apply threshold criteria and decide if it needs taking further
Goes to initial inquiries and investigation committees
What does a GPhC complaints investigation include?
Speaking to complainant and any witnesses
Speaking to pharmacist
Visiting registered pharmacy premises
May need to get witness statements from patients or other members of public
May formally interview pharmacists, their employees or owners of pharmacies
May seize evidence
What are the 3 statutory committees in the GPhC?
Investigating Committee
Fitness to Practice Committee
Appeals Committee
What is the difference between the Investigating committee and FtP committee?
FtP committee determines if FtP impaired - investigating committee cannot make a decision on this but can refer
What can the Investigating committee do?
Refer to FtP or give a waning that goes on the register, advice to person concerned and any other person involved
If reffered to the FtP committee, what initially has to be done?
Registrant has 14 days to give details of employer and organisation
Registrar must notify Secretary of State, employer, organisation
If FtP found to be impaired, may:
Give advice to any other person or body involved in investigation of allegation on any issue arising out of, or related to, allegation
Issue a warning (recorded in Register)
Impose conditions for up to 3 years
Suspend from practicing for up to 12 months
Remove from register
If FtP impaired due to adverse physical or mental health, what can the FtP committee NOT do? What do they do instead?
Register removal
Instead - give warning or direction
If FtP committee thing criminal proceedings should be considered, what must happen?
Notify registrar
Not FtP involvement
Criminal investigation then goes to FtP
How long do registrants have to produce records relating to their professional practice, if asked by assessors?
14 days otherwise may seek court order
What is an Interim Order?
Order that is put in place immediately to protect the public, before FtP committee have come together
What kind of interim orders are there?
Interim suspension order - registrant
Order for interim conditional entry - registrant
Interim suspension order - registered premises
How long do interim orders last?
18 months
When should interim orders be reviewed?
Within 6 months
Further review every 6 months (can request further after min 3 months)
May review if further evidence available.
After an interim order, what may the FtP committee do?
Revoke the order
Add to, remove or vary conditions imposed
If satisfied that it is necessary for protection of public or in public interest:
Can replace interim conditional with interim suspension order
Can replace interim suspension with interim conditional order
How long after removal can an application for restoration of name to the register be made?
Until at least 5 years after removal
Within 12 months of an earlier application