Satisfactory isn't good enough
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The GPhC’s new inspection procedure is proving a challenge for pharmacy teams, but it can also be an opportunity to prove their quality and value, explains Mukesh Lad, chairman of the LIPCO federated group
Over 2,000 pharmacies have been visited since the introduction of the GPhC’s new inspection regime in 2013. Inspection reports are not being published at the moment but this looks set to change. This concerns me.
From the inspections so far, pharmacy has returned a massive majority of mediocrity. What does this do for the image of our ‘satisfactory’ profession, when more than 90 per cent of those inspected are only one step above poor?
We cannot and must not overlook the implications of this for the future of community pharmacy. There’s little point in analysing whether concern should rest with the apparent pharmacy complacency or if the cause is the inspection model itself.
Either way, it’s time for pharmacy owners and their superintendents to step up. They are accountable for inspection outcomes and responsible for ensuring pharmacy teams are suitably prepared.
A benchmark for trust
The fundamental inspection principle is to protect the health, safety and wellbeing of patients, particularly when using pharmacy services. So the safety of medicines, their use and the effects of their incorrect use is our area of expertise. The quality and standard of our services provides the benchmark of trust and respect from our patients and public.
From a future commissioning perspective, it’s estimated that pharmacies across England could save the NHS more than £750m each year in preventable harm from medicines.
These criteria underpin our livelihood and we cannot afford to ignore them. We need to seize every opportunity to prove the all- round professional and ethical value we provide. We should also capitalise on every opportunity to improve how we do this.
Irrespective of whether a locum is in charge, staff are absent, or premises are undergoing maintenance, your pharmacy should, at all times, be operating in line with the inspection principles. They are governance, staff competency, premises condition, service delivery and equipment safety.
Room for improvement
During a recent CPD event for my Leicestershire Independent Pharmacy Company (LIPCO) federated group, I took time out to discuss the situation with NPA head of pharmacy services Leyla Hannbeck. Leyla is in regular contact with our professional governing body and without doubt, the independent sector needs to improve in several areas.
"We need to seize every opportunity to prove the all-round professional and ethical value we provide"
Most issues need investment in staff training as well as improved operations, processes and record keeping. Some concerns require financial input for premises improvement.
The key to a successful inspection is preparation. It’s important to maintain robust processes and data collection to provide the inspector with solid evidence of your standards within each of the five principles.
This isn’t an easy task when you’re operating at full stretch every day. But you shouldn’t shy away from getting professional support and advice.
In Leicestershire, we are creating a repository of resources for independent pharmacists on our LIPCO website. This way we can help one another step up to the mark.
Independents should go through inspection scenarios and how best to deal with them. Make sure your premises meet GPhC standards. Spend time reviewing a toolkit. Collect evidence and make sure it’s continually renewed by your team. Appoint a supervisor or technician to take a lead role to support any inspection.
Suitable procedures such as induction folders must be in place for locum
pharmacists. Make sure they can demonstrate updated information and knowledge of SOPs in order to operate the pharmacy in your absence.
Be prepared
Staff, including drivers, should be prepared to talk to the inspector on the day and be open when answering questions. Professional courtesy is implicit. Let the inspector know a locum will be on duty and any unavailable information will be forwarded immediately after the inspection.
If the inspector arrives just as you’re closing for lunch, be professional. Ultimately, by offering to remain on-site rather than telling him or her to come back later, you will be putting your own interests first.
Finally, promote yourself and your team and don’t be afraid to ask the inspector to provide you with advice. Make it a two-way process to prove your commitment.
This new inspection model is a prototype and there are noticeable shortfalls in the process. Only last month the GPhC responded to the widespread feeling that the ratings system isn’t right. It’s keen to hear what you think and you can do this either directly to the Council or via the NPA. Either way, it’s a route to making your views heard before legislation is passed and the standards become law.
Making your views heard
The regulator is planning to publish inspection ratings as soon as alternative labels have been developed. Hopefully, this will alleviate some of the concern about the public perception of pharmacy.
In the meantime, I urge you to capitalise on the opportunity to understand what ‘good’ looks like, gather examples of good practice and gain a better understanding of the new inspection model.
We need to think about our weaknesses and deal with them before someone else points them out to us. Mediocrity is not what pharmacy delivers. We are capable of much better, but we need to learn how to prove it.