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Practice procedures - Ensuring safety in dispensing

Follow these simple rules to create and update your practice guidance, says Kathie Applebee.

Standard operating procedures (SOPs) provide a safe framework for those responsible for dispensing medication.

Under the SOPs scheme introduced by the Royal Pharmaceutical Society of Great Britain (RPSGB) in 2005, pharmacies and dispensing practices are required to describe, in detail, the steps needed to undertake the various tasks that make up the work of dispensing.

These procedures should enable an experienced dispenser to work in a strange environment with little difficulty or risk, and help ensure that trainees are taught the correct procedural steps. SOPS should be checked annually and updated when procedures change.

Writing SOPs
SOPs should not be essays. They are designed for busy people and should be clear and concise, in bullet point or algorithm format. They are a series of steps that guide users through a process, and the format must enable each step to be distinguished.

Each document will be updated whenever working practices change, and it is crucial you set up a process of recording the changes. The documents should be numbered and dated, with a clear audit trail of changes so that both the changes and the previous documents can be inspected.

Ideally, all those involved in dispensing should have a part in developing the SOPs. This can be done by dividing the processes into stages, all of which are then written up by one or more individuals. Drafts can then be circulated for corrections or enhancements to be agreed.

It is good practice for SOPs to be signed by all staff when they have been created or updated.

Writing and updating SOPs are simple if you break down the tasks into small steps. The RPSGB lists six processes that should be covered by the SOP.

The first one - prescription handling - should be broken down into sections, including how to check patient details, then patient signature, collecting prescription charges, passing prescription for pharmaceutical assessment and assembly, advising patient of waiting time and procedures, completing documentation, legal and professional requirements for record keeping, endorsement and submission for pricing.

The other five recommended processes to be broken down in a similar way are: assessing the prescription for validity, safety and clinical appropriateness; making interventions and problem solving; assembly and labelling of required medicine; accuracy checking procedure; and transfer of the medicine to the patient.

As a simple framework for each of the processes required for developing the SOPs, start with the following questions.

Start with objectives - what is the procedure trying to achieve? Then look at scope - what areas of work are to be covered?

What are the stages - the details of how the task should be done? Who is responsible for carrying out each stage, including during staff absences?

Then ask is there any other relevant information that could be useful? And finally, how will you ensure it is updated? Keep it simple, and the guides are more likely to be followed.

Step-by-step guides
  • SOPS are guides to procedures to support clinical governance through risk management.
  • SOPS are specific to every site: they cannot be bought 'off the shelf' as they need to reflect local working practices.
  • They are a requirement for the Dispensing Services Quality Scheme (DSQS), and must be reviewed and updated at least annually.
  • SOPS provide guidance and are training tools for new and locum staff.
  • They clarify accountability in the event of delegation by senior staff.

Further information

Kathie Applebee is a strategic management partner at a dispensing practice in Cornwall

Contact Jacki Buist at GPdispensing@haymarket.com or (020) 8267 4865

The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit www.dispensingdoctor.org.uk

The DDA does not necessarily support or endorse the opinions or information contained on this page.

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