Empowering you to meet regulatory and best practice requirements

This month’s Patient Safety Champions’ letter focuses on some of the key elements of consultations that underpin the safe supply of medicines, whether over-the-counter (OTC) or dispensed in accordance with a prescription. While pharmacy team members are reading, understanding and implementing the updated OTC SOPs, your Patient Safety Champion will take this opportunity to help all members of the pharmacy team consider how they can enhance their patient interactions, with specific thought being given to prescription counselling and the sensitive refusal to supply an OTC medicine, which should all be underpinned by considering the circumstances and health literacy of your patients and customers.

A survey in 2018, which was funded by the National Institute for Health Research, found that 19% of the British population surveyed had some difficulty in reading and understanding health information and 23% had difficulty discussing health concerns with healthcare providers. The groups most likely to struggle were those with a limiting health condition or disability, the most socially deprived, or from black, Asian or minority ethnic communities.

When you and your team members provide counselling to customers when supplying an OTC medicine(s), it is important to give the correct information concisely, in a way that your patient can understand. The same applies when asking a customer for information regarding a symptom they are presenting with – it is important to ask the right questions in the right way. If you are unsure whether the customer has understood the information that has been given, ask them to confirm their understanding of what you have said and correct any miscommunication in a friendly, non-judgemental way.

In September 2020, after a successful trial, we launched the Codeine Patient Safety Card for use in all stores. The card was designed by Boots, in consultation with some key external stakeholders. The card should be used when selling codeine-containing medicines to reinforce the key safety messages. It is important that we showcase the value of pharmacy by educating our customers to support the safe and effective use of their medication. The card complements the CARE framework within The Boots Healthcare Way and acts as a prompt to ensure a high quality interaction. Please ensure that there is a supply of Codeine Patient Safety Cards available in store and that all team members understand how and when to use these effectively. Further supplies of the card can be ordered via ‘mystore’ (Linney) using the product code: WF53229/4329964.

An engagement document accompanied the launch in September 2020 – a copy of this can be found on BootsLive: https://nsp.bootslive.co.uk/sites/bootslive/AllUKNonOpticiansUsers/Pages/The-Professional-Standard-2020.aspx

The autumn and winter seasons bring an increase in cough and cold consultations and the subsequent sale of appropriate medicines, which is a great opportunity to champion our Boots Own Brand products. However, it is important to be mindful of the legal restrictions surrounding pseudoephedrine (PSE) and ephedrine (EPH), both of which may be misused or abused. Please remember that:

• It is illegal to sell any product that contains more than 720mg PSE or 180mg EPH without a prescription
• It is illegal to sell a product containing PSE and a product that contains EPH in one transaction
• It is illegal to sell a combination of products that, between them, total more than 720mg PSE or 180mg EPH without a prescription.

The Boots Healthcare Way, including the CARE framework, must be used in all such conversations with customers to ensure that they receive the best care.

Pharmacies are often the ‘first port of call’ for people seeking advice on minor ailments, some of which are sensitive in nature. We also now have more medicines available to purchase for conditions that could previously only be treated by prescription only medicine. It is necessary to ask the appropriate questions/use the relevant checklist to assess whether a medicine is suitable for the patient and requires personal information as part of such an assessment. It is often appropriate to use the consultation room or a quiet area of the store to support the customer or patient. When an interaction of this kind is required, it is important to remember that the chaperone policy is in place for both team members and customers, and a chaperone should be arranged if either person would like one to be present during the conversation/consultation.

The majority of our pharmacists are due to renew their GPhC registration and declare their fitness to practice by 31 October 2022. Pharmacists and pharmacy technicians due to renew their registration by (or after) 31 October 2022 (and whose registration expiry is due to expire on (or after) 31 December 2022) will need to submit six revalidation records, comprising of; four CPD records (two of which must be planned events), one peer discussion and one reflective account. Information on how to claim reimbursement of registration renewal fees from the Company is included in a letter that accompanied the printed September 2022 edition of The Professional Standard.

Please access the following link and complete the Independent Prescriber Registration Form to register your interest for future prescribing opportunities within Boots: https://www.bootslearning.co.uk/learn/#/course/d2f8d786-8226-40d5-8938-39d18d70a888

The September 2022 edition of the Drug Safety Update issued by the Medicines and Healthcare products Regulatory Agency (MHRA) advises prescribers and pharmacists to use caution if switching a patient between different long-acting formulations of methylphenidate (Concerta^® XL, Medikinet^® XL, Equasym^® XL, Ritalin^® LA and generic brands) as different instructions for use and different release profiles may affect symptom management. Long-acting formulations of methylphenidate should be prescribed by brand.

The Additional Dispensing Related Tasks standard operating procedures (SOPs) were updated and issued to stores in August 2022. An update to SOP AD1 (or SOP HAD1 for hospital stores) includes a new process for retaining evidence of dispensing errors. This is detailed within the ‘Investigate’ section and involves taking a photograph (using the store iPad) of any incorrect medication and attaching the image to the relevant dispensing error report within the Pharmacy Incidents & Events Reporting System (PIERS). If the incident resulted in moderate harm, severe harm or death (or if the level of harm is not known), the image should be reviewed by your Professional Standards & Quality Manager (PSQM) before it is uploaded to PIERS.