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

South West Medicines Information and Training. To check or not to check – that is the question?. Liz Fidler – Health Education Kent, Surrey & Sussex Ellen Williams – South West Medicines Information & Training. Learning outcomes. Discuss the roles and responsibilities of checking

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

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  1. South West Medicines Information and Training To check or not to check – that is the question? Liz Fidler – Health Education Kent, Surrey & Sussex Ellen Williams – South West Medicines Information & Training

  2. 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

  3. Who can be a checker?

  4. Responsible or Accountable – you decide??? • In groups look at your scenario and discuss who you think is • Responsible • Accountable

  5. Responsible Professionalism- regulatory/professional body membership? Accountable Legal – held to account Civil? Regulator?

  6. Debate – Technical ‘V’ Dispensary Checking

  7. 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?

  8. Next step for pharmacy technicians in technical services….Product Approval

  9. The South West Product Approval Pilot Project South West Medicines Information & Training

  10. 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. South West Medicines Information & Training

  11. 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) South West Medicines Information & Training

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

  13. A proposed Product Approval/Pharmacist Supervision model South West Medicines Information & Training

  14. Methodology Phase I South West Medicines Information & Training

  15. Methodology Phase II • Up 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. South West Medicines Information & Training

  16. Results & Outcomes Phase I • 17 learnersrecruited 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”. South West Medicines Information & Training

  17. Phase II • Data 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) South West Medicines Information & Training

  18. Implementation (1) 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. South West Medicines Information & Training

  19. 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 South West Medicines Information & Training

  20. 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 2013 Quality Assurance Specialist Pharmacist East and South East England Specialist Pharmacy Services Chair – NHS Aseptic Services Accreditation Working Group

  21. For more information about the SW Product Approval Accreditation Programme: SWMIT Website: www.swmit.nhs.uk Or contact Ellen Williams Ellen.williams@nhs.net 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. South West Medicines Information & Training

  22. Summarise • Views will be shared with NHS PEDC task and finish groups

  23. Any questions?

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