Are pharmacists under too much pressure?
Rhian Smith, Associate Solicitor in our Medical Negligence team, explores current pharmaceutical pressures and putting patient safety at risk.
In December 2016 the Department of Health began to cut community pharmacy funding. It is anticipated that cuts will total more than £200 million by March 2018, despite our population getting older and needs becoming more complex.
The BBC recently carried out a special investigation into a global business providing this crucial NHS service. The investigation sought to determine whether pharmacists are under too much pressure and whether inadequate staffing levels may be putting patient safety at risk.
It was stated that in a year, more than 17,000 incidents were voluntarily reported in community pharmacy. Incidents include system failures resulting from inadequate staffing levels, issues with training and/or issues with premises. Although we do not doubt patient safety is paramount to our pharmacists, these system failures have resulted in harm to patients and in some extreme cases, those mistakes have resulted in death.
Dispensing errors are usually a result of a failure to comply with company safety procedures and manifest in dispensing either the incorrect medication, or incorrect strength of medication, to patients. At particular risk of dispensing errors are the elderly, many of whom require complex combinations and/or high volumes of medications and may not be in a position to recognise a dispensing error.
Worryingly, the BBC investigation revealed anonymous reports of pharmacists having taken shortcuts when dispensing medications due to lack of time. Some described themselves to have been at “breaking point” having identified that mistakes may not be picked up on and patients could die as a result.
From a legal perspective, there is only requirement for one ‘responsible pharmacist’ i.e. the pharmacist in charge, to be present at the pharmacy. Regulators uphold that pharmacy owners are best placed to set their own staffing levels. However, responsible pharmacists can close their pharmacy temporarily should they deem practices unsafe. The BBC reported that in a research study looking at 400 pharmacies, 31 had closed temporarily for patient safety and, perhaps more alarmingly, 160 out of the 212 who had considered doing so didn't due to fears over the decision not being supported.
Where the most unfortunate outcome eventuates and a patient dies as a result of a dispensing error, the circumstances of the death may be investigated by a coroner. The BBC reported on three cases in particular in this regard. In the first case, the coroner identified clear opportunities for the error to have been be corrected. In the second, the coroner took the view that the pharmacist was unfortunately operating in a difficult situation, being busy and under pressure and had not followed operating procedures. In the final case, the coroner came to a different conclusion, in that understaffing did not play a part as the pharmacy was quiet at the time of the dispensing error. There was no defect in the system of working; the pharmacist simply didn't follow company procedures. Whatever the reason, there is clearly a cause for concern over patient safety in pharmacies across the UK.
Pharmacy law and ethics expert, Joy Wingfield, commented that the regulation around pharmacies is inadequate and standards need to be specified in respect of staffing levels. Further, she says the idea that these standards are too difficult to set and/or don’t allow sufficient flexibility needs to be challenged.
As a solution to the increasing pressures faced by pharmacists and in order to protect patients, the BBC investigation suggests that all pharmacies should follow one standard operating procedure. Fortunately, it revealed that new legislation is being put before Parliament which is hoped will encourage pharmacies to report more errors so lessons are learnt and future dispensing errors are minimised. The true extent of how the proposed legislation will combat the cuts to community pharmacy funding is yet to be determined.
Sadly, although dispensing errors are rare, we are often approached by patients who have experienced dispensing errors and we understand the tragic impacts these mistakes can have on patients and their families. At JCP Solicitors we are skilled at dealing with cases in respect of dispensing errors. Please do not hesitate to contact us for a free initial consultation with no obligation if you require any further information or suspect that you or a family member has suffered an injury as a result of negligent treatment.
Rhian has a personable manner and strives to be of support and assistance to each of her clients throughout the medical negligence claims process. She is skilled at providing advice to victims of medical negligence and their families during what can be a very difficult time. For more information please contact Rhian on 01792 525 432 or email firstname.lastname@example.org.
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