The way pharmacists work will not change
I wish to comment on Brian Curwain’s letter on the government’s proposal to decriminalise dispensing errors (The Pharmaceutical Journal 2015;294:211). I am not convinced that the decriminalisation of dispensing errors will change the way in which pharmacists work.
During the years of my career as a pharmacist, I was blissfully unaware that I could have received a criminal record from the commission of a human error and so I was not frightened by this prospect. I was, of course, aware that the regulator’s Statutory Committee could take away my livelihood but it was not this thought that kept me on the straight and narrow. I would like to think that it was more down to my striving to give a first-class service to patients both in dispensing and advice. In order to perform the latter function I had to rely on my support staff, especially dispensing technicians. This is where the main problem lies. In order to maximise the time the pharmacist has available for patient consultation, every pharmacy, large or small, should have a minimum of one accredited checking technician and one other technician or trained dispensing assistant.
Technicians make fewer dispensing errors than pharmacists and it is generally assumed that this is because they concentrate on dispensing whereas pharmacists are trying to perform several functions simultaneously. I found that the most rewarding part of my practice was talking to patients about their medicines or health problems and I am sure most pharmacists will agree.
It is also valuable to the well-being of the practice as a whole since patients feel relaxed and confident about their visits to the pharmacy. Unfortunately it is impossible to quantify these benefits financially, meaning that employers set targets on measurable factors such as prescription numbers and medicines use reviews. They then set minimum staffing levels, forcing pharmacists to spend more time in the dispensary, which can lead to more errors. Independent pharmacists have much greater control over their staffing levels than multiples due to comparatively lower overheads but even those not driven solely by profit can only go so far in their search for the perfect equilibrium.
We all want to see errors kept to a minimum and the practice of recording errors and near-misses has been a major factor in improving patient safety. In a similar way, computer systems that allow the detailed recording of interventions provide security to pharmacists and GPs and give confidence to patients.
Although the threat of criminal proceedings for genuine human errors being removed will be a huge relief to pharmacists, this alone will not enable pharmacists to leave the dispensary as required. What is needed is a comprehensive review of what the average pharmacist is doing and funding adjusted accordingly. The application of such funding will then need monitoring to ensure that the required service is being delivered.
Roger M King
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20067973
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