Community pharmacy safety may be improving, but concerns remain

 

The Pharmacist Defence Association (PDA) has released the headline results of their annual safer pharmacies survey, in which pharmacists disclose how often the basic safety commitments detailed in the Safer Pharmacies Charter have been met in their direct experience of practice. Top-level results show a small improvement in 2019 compared to the previous year, but the PDA have said there is ‘still a long way to go’.

 

Over recent years the PDA has undertaken a series of surveys seeking member feedback on working conditions in community pharmacy. This led to the development of the Safer Pharmacies Charter in 2017 and since the charter was launched the PDA surveys have monitored safety against the charter standards. The summary results below are from the 2019 survey.

 

A more in-depth analysis will be shared at the PDA National Conference in Birmingham on 28^th and 29^th March 2020.

 

PDA members produced the charter of seven commitments to improve safety and care for patients, through better working conditions in UK registered pharmacies. The charter defines basic standards to ensure safe practice.

 

The 2019 survey of over 1,000 pharmacists shows a broadly positive shift across each of the basic safety commitments, suggesting that overall basic safety is being met more often than it appeared to be met in 2018.

 

However, the PDA has said that the frequency of instances where the standards are not met should remain a real concern for those responsible for pharmacy safety. As examples, among the most concerning results in the survey are that, whilst slightly better than last year, 69.8% of respondents still report that there is inadequate staffing in the pharmacy, and 59.5% of respondents said they did not have adequate rest, at least half of the time.

 

Alima Batchelor, Head of Policy at PDA said

 

“Whilst the results are slightly improved from the previous survey, there is still a long way to go to significantly improve safety. The PDA circulates a Safer Pharmacies survey on an annual basis and will be launching the 2020 survey later in the year. We would encourage all pharmacists working in registered community pharmacies either on the high street or in hospital outpatient departments to complete the survey so that we can continue to monitor trends and raise issues of concern if they arise.”

We have summarised the survey results for each principle below.

 

Each of the basic safety commitments should be met all the time and that is the target which each person responsible for patient safety should be attempting to achieve in the pharmacies for which they have control.

 

 

Principle one – No self-checking

 

Where pharmacists are directly involved in dispensing, or other processes requiring a high degree of accuracy, a suitably trained and competent member of staff will be readily available in the pharmacy at all times to provide an independent accuracy check. An independent second check improves patient safety by preventing errors.

 

 

Principle two – Safe staffing

 

Staffing levels will be sufficient to allow all legal, contractual and regulatory obligations to be met; to meet the workload involved in following standard operating procedures and to carry out other work in accordance with the organisation’s expectations. All staff must be suitably trained and competent to carry out the pharmacy work they are involved in. Providing enough suitably trained staff improves patient safety, quality of care and service.

 

 

Principle three – Access to a pharmacist

 

A pharmacist is traditionally one of the few healthcare professionals accessible to patients without an appointment. A pharmacist must be available wherever patients expect immediate access to face-to-face expert advice on any medicine-related matters. The pharmacy owner or employer will meet this expectation by ensuring a pharmacist is available to patients and present in the pharmacy throughout its hours of operation. Pharmacists are the experts in medicines and must be present to ensure that medicines provided to patients are safe and appropriate.

 

 

Principle four – Adequate rest

 

Pharmacists must be able to take at least their statutory and contractual breaks and rest periods, and additional breaks as required to meet their professional obligations. Pharmacists will be enabled to take these without interruption and will not be placed under any direct or indirect pressure to forfeit. To keep patients safe, pharmacists must be alert at work.

 

 

Principle five – Respect for professional judgement

 

Pharmacists will be enabled and encouraged to exercise professional decision-making in the workplace, so that patient safety and professional standards can be placed above any commercial or other operational considerations. Organisational and other targets must not inhibit professional autonomy. As health professionals, pharmacists put patients’ health first.

 

 

Principle six – Raising concerns

 

Pharmacists will be able to raise concerns without reprisal or fear. This will be facilitated by a supportive, open and receptive organisational culture. Issues identified will be promptly addressed and robust and enduring solutions implemented without delay. Concerns at work which could impact on patient safety need to be raised and resolved without delay.

 

 

Principle seven – Physically safe

 

Pharmacists will not have to work in the pharmacy alone and will have access to the necessary support at all times to perform their roles. Risks will be assessed and preventive measures put in place so that patients and staff are safe – and can feel safe. A zero-tolerance approach will be taken to violence or abuse of pharmacists and other pharmacy staff. Pharmacies need to be safe places for patients, pharmacists and everyone.

 

 

Summary

 

The percentage of pharmacists answering either “None of the time; Minority of the time; Around half the time; Most of the time” or “All of the time” to when each of the charter commitments is met is as follows:

 

 

Those responsible for pharmacy safety should be working tirelessly to get these basic commitments met all of the time in the interest of patients and pharmacists.

 

You can find out more and book places at the PDA National Conference 2020 here. Copies of earlier PDA Safety Surveys can be found here.