Focus on excellent practice in pharmacies

27 April 2017

We hope that this series of articles, sharing examples of what we are seeing through our inspections of registered pharmacies, can prompt discussion and help pharmacy owners and the pharmacy team continually improve the services they provide to patients and the public. At the heart of our strategy for regulation is ‘assurance’ and ‘improvement’. This month, we are focusing on excellent practice within pharmacies.

This isn't limited to those pharmacies that were considered ‘excellent’ overall- it also recognises pharmacy teams who demonstrated particular areas of excellence.

We want to highlight:

  • examples of what innovation in the design and delivery of pharmacy services can look like
  • how pharmacy professionals are being proactive in the services they provide
  • how pharmacy teams are demonstrating positive outcomes for their local communities

It’s important to understand that there are many different ways to be excellent. What works in one pharmacy may not be the best option for another pharmacy. It’s about the leadership, culture and context, making the most of your networks and partnerships, targeting your resources and efforts, and working for the best possible outcomes for your local communities.

The case studies below are examples from pharmacies we have seen which demonstrated particular areas of excellent practice.

  • Pharmacy professionals who owned and worked at a community pharmacy focused on developing new services in response to the needs and expectations of the local community. There were a large number of patients in the community suffering from varying degrees of dementia so a need was identified to increase awareness, information and services for staff, patients and carers. A regular patient increasingly forgot where she stayed resulting in a member of staff taking her home, and it was discovered that this was also happening late at night with other locals assisting her. This is just one example which prompted one of the pharmacists to undertake personal training and development and to become involved with other healthcare professionals including specialists on a dementia project. The pharmacy team developed a toolkit to be used in pharmacies which included training material for pharmacy staff, agencies to signpost patients to, and an audit to undertake in the pharmacy to assess its ‘dementia friendliness’. While initially intended for use in this particular pharmacy, this resource has since been shared with a range of other pharmacies, the Royal Pharmaceutical Society, distributed at LPF events on dementia and used by a university. All pharmacy staff were trained by a national dementia charity and a clinic was set up in the pharmacy with weekly drop-in sessions for patients, carers and families to access support. The pharmacist regularly worked on projects with other healthcare professionals such as a dementia garden as part of a treatment plan, and was involved with local fundraising for the condition.
     
  • The pharmacy team at a rural village pharmacy believed that the Chronic Medication Service for patients with long-term conditions was an integral part of pharmacy life. The pharmacist worked hard to provide a good service which focused on positive patient outcomes rather than serial prescribing. A lot of work was done to synchronise patients’ prescriptions to ensure that all medicine was running at the same time. Following discussion with the local GP, it was agreed the pharmacist could have autonomy to synchronise these himself and this had proved to have a very positive outcome for patients. The GP presented the results in a national newsletter for GPs and discussed it at a local GP event. The pharmacist was invited to attend a working group regarding promotion of this throughout the health board area, and to share his experiences and encourage other pharmacists to get involved.
     
  • The pharmacy team at an independent pharmacy close to a city centre was particularly involved and passionate about the care of their local community and the overall success of the pharmacy. The team was confident to feedback ideas and concerns, and their views were actively encouraged and recognised by the company. The team felt that the superintendent pharmacist operated an ‘open door’ policy and was always approachable. One particular example of responding to staff feedback involved the introduction of coloured folders to manage records and prescriptions for patients on high risk medicines; the folders prompted staff to ensure a six step checking procedure was completed before the high risk medicine was supplied. The pharmacy team also worked with a patient group and specialist substance misuse services to produce a health promotion video. This rolling video was played on TV screens in designated areas and received positive feedback from people using the pharmacy services. The pharmacy team were familiar with users of the substance misuse programme and described the extra checks they would make if they noticed any changes in behaviour.
     
  • The pharmacy team at a village pharmacy established great links with the local community, patients and other healthcare professionals. This led to an improvement in how patients used and understood their medicines, with positive outcomes. The pharmacist attended local events to introduce himself, represent the pharmacy and promote targeted pharmacy services. This included attending a children’s hospice open event to see what activities were undertaken at the hospice, create links with the care team, highlight services that the pharmacy offered, and invite discussions on how the pharmacy team could help with the children’s care. The pharmacist was an independent prescriber who held fortnightly pain management clinics with the local surgery, and had joined up with a local physiotherapy service. This resulted in better quality advice and treatment for patients, and increased referrals for painkillers and anti-inflammatory medications due to the pharmacist’s expertise in pain management.
     
  • A pharmacy team working in an integrated health and social care centre had an excellent understanding of the community they served and tailored their services to its needs. Five members of the pharmacy team, including all three pharmacists, spoke a second language. The team reflected on how they were able to use these skills to communicate effectively with the local Asian and European population who did not speak fluent English. The pharmacy also made health information leaflets available in multiple languages in order to meet patients’ needs. The team were committed to increasing compliance, reducing medicine waste, and decreasing the risk of safety incidents caused by patients hoarding medicines. The pharmacy provided meaningful interventions, half of which (approximately 150 per month) were delivered through the ‘not dispensed’ scheme where the pharmacy team worked to identify patients who may have unnecessary, unwanted or clinically inappropriate prescriptions. Other interventions included targeting specific groups of patients to provide counselling on the appropriate use of medicines, checking medication routines, and providing information about medicines and chronic health conditions. The pharmacists identified that death rates caused by respiratory disease in the local area were higher than the national average. The team then targeted patients on inhalers by providing inhaler technique checks, advising them of the correct inspiratory flow required using an In-Check Dial, and helped to identify more effective medicine regimes through liaison with the asthma nurse.
     
  • The pharmacy team at the only pharmacy in a village adjoining a small town recognised that a number of patients visiting the pharmacy were potentially vulnerable as there was a homeless shelter nearby. The pharmacist took a proactive approach and worked with local agencies to issue vouchers for a foodbank run by local churches, which entitled individuals to food packages for three weeks. The service was available and delivered in a very professional, but low key, way by all staff members.

We take a 'show me, tell me' approach to inspection so remember to tell us about all the really good things you’re doing at your next inspection!

Find out more

Here are some of the resources available to help you and your team find out more.

Read the GPhC’s: