to check or not to check – that is the question?

To check or not to check – that is the question?

Liz Fidler – Health Education Kent, Surrey & SussexEllen Williams – South West Medicines Information & Training

South West Medicines Information and Training

Learning outcomes

Discuss the roles and responsibilities of checking

Debating who can/should check Debating the differences in checking in a

Dispensary V a technical services unit Exploring the potential of transferability

between the two roles for rotational staff Discuss the development of Pharmacy

Technician Product Approval in Technical Services

Who can be a checker?

Responsible or Accountable – you decide???

In groups look at your scenario and discuss who you think is Responsible Accountable

Responsible

Professionalism- regulatory/professional body membership?

Accountable

Legal – held to account

Civil? Regulator?

Debate – Technical ‘V’ Dispensary Checking

Common ground

Need? Transferability Career progression NHS Scoping exercise results

What does that look like? One qualification – theory

Checking procedure Error reporting Communication skills – error feedback (learning) Law?

Does this feel right? What do you think it should include?

Next step for pharmacy technicians in technical services….

Product Approval

The South West Product Approval Pilot Project

South West Medicines Information & Training

Project Aim

To develop and deliver a functional and high-quality training programme for individuals who carry out the task of “product approval” for aseptic products.

To develop and work within an operating framework that ensured that pharmacist supervision was in place.

To address the training requirements of pharmacists and registered pharmacy technicians.


Background

Pre and In process checking (since 2005)◦ 66 pharmacy technicians/ATOs are currently on the SWMIT register

Feedback◦ Improved standards ◦ Improved confidence

Current Situation◦ Lack of training for rotational band 6/7 authorised pharmacists◦ Lack of confidence and understanding of responsibility when releasing a product ◦ The need to train in restricted time frames

There is a requirement to release products during the first three month rotation◦ Clinical issues are being picked up at the end of the process (at the point of product

approval)


What has been the barrier to pharmacy technicians product approving and releasing in technical services historically?

A proposed Product Approval/Pharmacist Supervision model


Methodology Phase I


Phase IIUp to 100 products per site prepared under section 10 exemption were recorded

Details of the clinical screening, prescription verification, preparation and product approval processes were documented

Details of the product, pathway for product approval, trained pharmacy technician approver or authorised pharmacist, and the recommendations for approval and associated outcomes.

All products approved by trained pharmacy technician product approvers MUST have been second checked.

Methodology


Results & Outcomes

Phase I

17 learners recruited in 2 cohorts

13 successfully met all of the assessment criteria to demonstrate their skills, knowledge and competencies.

Indicates the power of the assessment process to discriminate between learners. Provides an appropriate degree of assurance that individuals can perform the task of product approval at a safe level and operate as “Accredited Product Approvers”.


Phase IIData on over 500 individual preparations

96% of products were clinically checked and verified prior to preparation.

93% were suitable for release by an Accredited Product Approver clinically checked and verified by an appropriate

pharmacist(s) prior to preparation the product itself was suitable.

3 discrepancies out of 193 products approved On review, these cases involved minor technical issues and

in no case would have impacted on patient safety. 2 omitted additional “room temperature storage” labels 1 incorrect worksheet (wrong dose band)


The new SW accreditation programme includes the following components:

The unit would need…….

Approval by Regional QA to incorporate Accredited Product Approvers. Trust board, Senior Pharmacy manager and Accountable Pharmacist authorisation for change in process.Regional QA approval of candidates selected.Participation in national error reporting scheme.

Implementation (1)


Implementation (2)

Trainees will require….

•Completion of pre-course tasks and learning.•Two day training course.•Six week period of experience, supervised checking and collection of evidence (at least 50 items). Missed errors would require restart of this process.•Summative practical and viva voce examination. Failure would require re-sit or restart.•Accreditation and commencement of probationary period.•Reaccreditation


First formal induction course ran 8th/9th May 2013

Next steps…

“The work of the NHS Aseptic Services Accreditation Working Group will now focus on working with members of the SW Product Approval Accreditation Programme to develop a national framework to support the wider roll out of this initiative.

This work stream will commence mid 2013.

It must be noted that the definition of supervision cannot be considered in isolation and must be fully supported by a framework that gives the same levels of resource, governance and oversight that has been incorporated into the South West Programme”

Richard Bateman, May 2013Quality Assurance Specialist PharmacistEast and South East England Specialist Pharmacy ServicesChair – NHS Aseptic Services Accreditation Working Group

For more information about the SW Product Approval Accreditation Programme:

SWMIT Website:www.swmit.nhs.uk

Or contact Ellen [email protected]

Acknowledgements

Thanks to members of the SW Product Approval Pilot Project regional steering group and the NHS Aseptic Services Accreditations Working Group for their support with the Product Approval project.


Summarise

Views will be shared with NHS PEDC task and finish groups

Any questions?

to check or not to check – that is the question?

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