Dispensing practices receive more outstanding and good ratings compared to the average for all GPs, and they receive fewer inadequate or improvement needed notices, data from the CQC shows.
This shows that of 656 dispensing practices inspected:
- 6% are outstanding (45)
- 84% are good (557)
- 6% require improvement (45)
- 1.4% are inadequate (9)
As of July 21, the CQC had inspected 2555 non-dispensing GP practices, and awarded the following ratings:
- 3.5% are outstanding (89)
- 81% are good (2072)
- 12.4% require improvement (316)
- 3.1% are inadequate (78)
Some 80 per cent of the 1036 dispensing practices in England, are DDA members.
Three reports of dispensing practices have been published since our last review of practices rated outstanding and inadequate b the CQC
DDA member the Cartmel Surgery, in Grange Over Sands, Cumbria, has been rated outstanding overall by the CQC. The dispensary contributed to an outstanding rating for caring. In particular, inspectors noted that in an in-house survey, the practice dispensary had been rated at least very good by patients asked about the dispensary staff’s response to queries about prescriptions. The practice was also rated outstanding for responsiveness to people’s needs.
Rated good for safety, the inspectors noted the following dispensary features:
- The arrangements for managing medicines, including emergency medicines and vaccines, in the practice kept patients safe (including obtaining, prescribing, recording, handling, storing, security and disposal)
- Processes were in place for handling repeat prescriptions which included the review of high risk medicines
- The practice carried out regular medicines audits
- Blank prescription forms and pads were securely stored and there were systems in place to monitor their use
- There was a named GP responsible for the dispensary and all members of staff involved in dispensing medicines had received appropriate training and had opportunities for continuing learning and development
- Any medicines incidents or ‘near misses’ were recorded for learning and the practice had a system in place to monitor the quality of the dispensing process
- Dispensary staff showed us standard procedures which covered all aspects of the dispensing process.
- The practice held stocks of controlled drugs (medicines that require extra checks and special storage because of their potential misuse) and had procedures in place to manage them safely. There were also arrangements in place for the destruction of controlled drugs
- There were records of appropriate recruitment and Disclosure and Barring Service checks.
DDA member, Boughton Surgery, near Kings Lynn, has been rated good for caring and responsiveness, but inadequate overall after a follow-up inspection.
The report of the follow-up inspection does not include any mandatory or recommended actions specifically directed at the dispensary. Since its previous inspection:
- The practice had taken reasonable steps to ensure the safe management of medicines.
- The practice had developed a process for monitoring the collection of dispensed prescriptions at external allocations
- The safety of medicines stored within the dispensary had improved and medicines were better organised.
Northcote House Surgery, St Ives was also rated good for caring and responsiveness, but inadequate overall.
The practice was signed up to the Dispensing Services Quality Scheme (DSQS) and dispensing staff were appropriately qualified, were offered on-going training opportunities and had their competency annually reviewed.
The practice had written procedures in place for the production of prescriptions and dispensing of medicines that were regularly reviewed. There were a variety of ways available to patients to order their repeat prescriptions and there were arrangements in place to provide medicines compliance aids.
Following the comprehensive inspection, the practice was told to make the following mandatory improvements to its dispensing service:
- Ensure appropriate security systems are in place so that only authorised practice staff can access the dispensary
- A risk analysis must be carried out on the safe transport and storage of medicines to the branch surgery
- Ensure all emergency prescriptions issued are signed by a GP before being issued to a patient
- Ensure that staff caring for patients have undergone a Disclosure and Barring Service check (DBS)
- Ensure all staff training deemed mandatory by the practice is up to date, including training for safeguarding
- Ensure all policies, procedures and guidance are up to date so that staff are able to operate in accordance with up to date procedures
- The practice must comply with relevant Patient Safety Alerts issued from the Medicines and Healthcare products Agency (MHRA) and through the Central Alerting System (CAS).
Recommended areas for improvements are:
- Ensure thermometers used to record refrigerator and room temperatures where medicines are stored are validated before use to ensure their accuracy
- Ensure effective control of substances hazardous to health is in place
- Ensure blank prescription forms are kept securely at all times.