The DDA will respond to a CQC consultation which introduces a safety assessment of the reliability of systems, processes and practices to ensure proper and safe handling of medicines.
The new assessment, which contributes to a practice’s safety rating, will scrutinise the following aspects of dispensing practice:
- Are medicines ordered, transported and stored safely and securely (including medical gases and emergency medicines and equipment)?
- Are blank prescription forms stored safely and tracked in line with NHS Protect guidance?
- Is there a system in place for completing medicine reconciliation in line with NICE guidance?
- Are medicines administered safely and recorded in notes?
- Where indicated, is therapeutic drug monitoring and physical health monitoring completed and are appropriate interventions made?
- Are people’s medicines regularly reviewed including the use of ‘when required’ medicines?
- Are patient group directions (PGDs) and guidelines for the use of medicines in date, properly authorised and legally operated?
The consultation also proposes a number of other additions and changes that will apply to the dispensary, as well as other areas of the practice. According to the CQC, the changes aim to reduce complexity and create more consistency. Among the additions to the safety domain are the following enquiry prompts:
- How effective are the arrangements to respond to relevant external safety alerts, recalls, inquiries, investigations or reviews? Are these audited?
Among the enquiry prompts to be changed in the consultation are the following:
- How are staffing levels and skill mix planned and reviewed so that people receive safe care and treatment at all times and staff do not work excessive hours?
- When things go wrong, are thorough and robust reviews, investigations or significant event analyses carried out? Are all relevant staff, services, partner organisations and people who use services involved in the review or investigation? Do staff participate in learning led by other services or organisations?
Information on other proposed additions and changes to the lines of enquiry and prompts within all five inspection ratings characteristics are detailed in Annex 1a of the consultation documents. Responses can be sent by email and must be received by Tuesday 14 February.
The consultation also provides clarity for awarding ratings. On the new assessment for the reliability of systems, processes and practices to ensure proper and safe handling of medicines, the CQC gives the following information:
Outstanding: Staff not only meet good practice standards in relation to national guidance, they also contribute to research and development of national guidance. Compliance with medicines policy and procedure is routinely monitored and action plans are always implemented promptly.
Good: Staff meet good practice standards described in relevant national guidance, including in relation to non-prescribed medicines. People receive their medicines as prescribed. The service involves them in regular medicines reviews. Staff manage medicines consistently and safely. Medicines are stored correctly, and disposed of safely. Staff keep accurate records of medicines.
Requires improvement: People do not always receive their medicines as prescribed. The service does not always follow relevant national guidelines around storing medicines, administering them, and disposing of them. This includes in relation to nonprescribed medicines.
Inadequate: People are at risk because staff do not administer medicines safely or people do not receive them as prescribed. Medicines are not ordered, transported or stored safely or securely.