A number of incidents reported to PDL in recent months has exposed some deficiencies that are occurring in pharmacies around Australia.
One issue that has emerged is that some proprietors have failed to check the assumed credentials of a pharmacist employed by them. In one case, a proprietor employed a pharmacist who was not actually qualified and registered with AHPRA. This oversight will have serious ramifications with the pharmacy regulators and could jeopardize the pharmacy’s professional indemnity insurance. When employing pharmacists, the proprietor should request registration details and also check the AHPRA register to ensure no conditions apply that will affect employment. The same checks will also be required for proprietors engaging AACP accredited pharmacists or accredited Diabetes Educators.
Pharmacist vaccination provides another area where both proprietors and employed pharmacists need to be aware of current requirements that apply in the state they practice. Most jurisdictions require vaccinators to regularly update their first aid and CPR training. It is prudent that proprietors request proof of this before they allow pharmacists to immunise in their workplace.
Another serious deficiency occurring in some pharmacies relates to the lack of current contact details of clients receiving opioid replacement therapy. This was demonstrated recently when a locum pharmacist accidently provided methadone takeaways that were twice the correct dose. This pharmacist desperately tried to contact the client to remedy the situation by using the phone number and address listed in the pharmacy records. It eventuated that these details were two years out of date and the client was only found with the help of the local police in the middle of the night. As it is common for some Opioid Replacement Therapy (ORT) clients to regularly change address and phone numbers, pharmacy proprietors should ensure that client’s details are regularly checked and updated. One pharmacy went as far as refusing to dose their clients without firstly checking current contact points in case of an emergency arsing such as the one mentioned above. Having up to date contact records of customers applies to all pharmacies irrespective of whether ORT is supplied.
Scenarios have arisen where interstate owners have never visited their pharmacies and it is problematic. A proprietor is advised to visit the premises regularly where possible and maintain open lines of communication with employee pharmacists. This will help ensure consistent dispensing patterns, to reinforce to staff the importance of appropriate counselling and about the appropriate dispensing practices, supervision, storage of S3s behind counter, appropriate checking of out of date stock and general training of staff in pharmacy procedures. Complaints and notifications are not just bringing action against the individual pharmacist in charge, or involved in the dispensing, but also against the proprietors. Stern action is being taken against proprietors because they have the legal and professional obligation.
A final and important matter to bring to the attention of proprietors is the regulatory requirement to have oversight into all aspects of any business they may have an interest in. The Pharmacy Board of Australia Guidelines for Proprietor Pharmacists state that proprietors maintain an active interest in how the pharmacy business is conducted and proprietor pharmacists cannot delegate their professional obligations.
These principles were clearly demonstrated in a pharmacy where a large amount of S8 drugs were diverted by an employed pharmacist. Although the proprietor was not directly involved with the business at the time of the thefts, the regulator imposed conditions on their registration as it was considered that oversight of the pharmacy must have been inadequate for this diversion to occur. One method for proprietors to maintain oversight of a pharmacy would be to require the Pharmacist in Charge to provide regular reports on the audits of the S8 inventory. Had this been done in the case mentioned above, the problem may have been prevented or detected much sooner.
It is important proprietors are checking off that the pharmacy business professional and ethical requirements are being satisfied. PDL provides a sense of security for pharmacy owners as well as pharmacist employees. We assist proprietor members through professional advice, recommendations and guidance to ensure the pharmacy business is meeting legal requirements.
“The role of pharmacy staff in preventing dispensing errors” course has been launched by GuildEd. Find out more.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7, Australia-wide.