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Letters to the Editor
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Safety
Risk management
From Mr A. J. Jukes, MRPharmS
It is a requirement for us all under the “Standards of professional
performance” in the Code of Ethics to be concerned primarily for
the wellbeing and safety of patients and the public. However, I think across
the broad area of services in community and hospital pharmacy, this is
becoming an increasingly difficult concept to adhere to.
There is a multitude of diverse processes affecting the ability of hospital
and community pharmacies to manage their workloads effectively and safely,
and it is time that someone started to look seriously at how such factors
are putting patients at risk and do something to effect some change.
In the hospital sector there may be miscommunication within the system
that means that pharmacists spend a lot of time contacting prescribers
and wards for details that should be mandatory on prescriptions. The turnover
of patients is high and there is only a short time to complete a large
number of discharge prescriptions with little communication from wards.
Hence these prescriptions are not being processed with maximal efficiency.
Financial pressures have caused a fall in staffing levels and this is definitely
impacting on effective risk management, despite systems being in place.
Colleagues have mentioned that they have had to cover 30 beds in 20 minutes
in some hospitals and I would question whether a pharmacist’s eyes
have time to focus on the ink let alone provide pharmaceutical care in
that time. The whole system is at breaking point but the impact on a pharmacist
being able to give good quality care and follow the standards of professional
performance is questionable.
In the community sector, the introduction of new service provision, increased
prescription volume and an ever-demanding public mean that pharmacists
can be divided between tasks which increases the risk of them making a
mistake.
In both sectors there needs to be a rethink and honest assessment of whether
we are compromising patient safety. The low staffing, lack of sufficient
work breaks and lack of time to do tasks properly against higher patient
demand is an accident waiting to happen. I applaud the Pharmacists’ Defence
Association for its work on work breaks and support staff but there needs
to be more done to address these issues because they are impacting directly
on the risk management of processes affecting patients and our “standards
of professional performance”.
I realise some of the solutions are complex and involve government-directed
organisation of health care trusts and retail service contracts but, surely
as a profession we need to do our part in responding to these increasing
pressures in order to achieve safe working practices.
Andrew Jukes
Brighton |
The
Pharmaceutical Journal