Top 8 Tips for passing your Accuracy Checking final assessment

Janita Patel, an NPA L&D pharmacist, sets out eight top tips to help students pass their final assessment.

NPA ACT final assessment

 

Janita Patel, the NPA’s Learning and Development pharmacist responsible for its Accuracy checking courses sets out eight top tips below to help students to pass their final assessment. These tips have been compiled based on Janita’s experience of running the NPA final assessments in recent years and feedback provided by students.

    1. In advance of the final assessment, we strongly recommend that you ask your supervisor to set up at least one mock exam so you can practise accuracy checking of prescriptions in a quiet environment and under timed conditions – more details are available in your tutor and trainee guides.
    2. On the day of the final assessment once you have checked a prescription and moved on to another, if you feel you have made a mistake and/or remember something you didn’t note, you are not allowed to go back.
    3. You are not required to do any legal checks – assume these have already been done. This means, do not worry about the date on the Rx or if it is signed.
    4. You do not have to check that the correct cautionary labels are in place, assume this has been done for you.
    5. Do not worry about clinical checking – this is the Pharmacist’s role – not that of the accuracy checking technician (ACT).
    6. Do write all errors that you find clearly on your answer sheet. If your writing is unclear, your answer may be misinterpreted and may result in you losing marks.ACT final assessment answer sheet
      – Example 1
      Picking error – THIS IS NOT ACCEPTABLE. This is not an error – it is a reason for the error. By providing a vague answer like this, it is unclear if the drug was incorrect or the form.
      Correct answers
      Either number each product in the order it appears on the Rx or simply write the name of the product and the error, e.g.
      a) Wrong drug
      b) Expired product– Example 2
      Just writing ‘Wrong label’, if in fact the labels were transposed. If you have failed to pick up that both items in the basket had wrong labels, you will have lost a mark – as in practice, you may have corrected one label but not the other. So either write ‘transposed labels for item 1 and 2’ or ‘Item 1 – wrong label’ and ‘Item 2 – wrong label’.
      Correct answers
      a) Amlodipine – wrong drug
      b) Simvastatin – expired product
    7. Do not stop checking if the product has expired, there could be more than one error. In practice, if your thoughts are to leave that product to one side because it has expired and pick a non-expired product, you may have transferred a label with an error still on it onto the new product.
    8. Pace yourself well. Often candidates go very slowly on the first ten prescriptions and then have to rush for the last five, which is where they miss errors.

By observing the eight tips above, we’re confident that you’ll be on the right track to pass your final assessment. Good Luck!

We’re taking a Primary Care Network journey. Want to come along?

By Paul Brett, Monkbar Pharmacy

Primary Care Networks (PCN) officially came into being at the beginning of July.  Liaising with our local pharmaceutical committee and supported by the National Pharmacy Association, we will actively engage with our local PCN in the months ahead.

We’re going to tweet and blog about our experiences along the way, so that you can see our highs and lows and maybe you can start your own ‘PCN Journey’ with the help of your local pharmaceutical committee.  If we can do it, you can do it too!

We own a 100 hour pharmacy inside the beautiful walled city of York. Monkbar Pharmacy was opened by me and my friend and colleague Neil, after years of dreaming of creating a pharmacy which would be designed entirely around the needs of customers.  The initial fundamental principles of going that extra mile and doing away with targets for staff, so that they are free to focus on the needs of the individual are just as strong as ever, although increasingly challenging in these times.

My wife Vikki has been with us throughout, but this year has become much more involved and is using her skills gained during a long career in the NHS, and her passion for collaborative working to forge new relationships within the local healthcare community.

Our future as a community pharmacy business is to some extent dependent on how well we engage with the local NHS on the delivery of clinical services.  The new way to get involved in England is through Primary Care Networks, so over the next few months we’re going to do our best to establish a clear understanding of what the local PCN is all about.  We’ll start to build relationships with GPs and PCN officers too, within a framework discussed with the local pharmaceutical committee.

We are co-ordinating this with our LPC, because it’s not a good idea for individual contractors to go it alone at this stage.  Recent guidance from NHS England describes how LPCs should go about engaging with PCNs and gives an indication of timeframes.

The NPA is also helping us to take this journey, including business coaching from Michael Lennox who is working for the NPA on a part time basis.  Michael has been chief exec of Somerset LPC for three years and that area is quite advanced in terms of community pharmacy engagement with LPCs – so we’re looking forward to benefitting from his experience there.  We’ve never been on this journey before, so it’s great to have the NPA help navigate this for us.

Watch out for our blogs and social media posts (#mypcnjourney) from September.  InPharmacy magazine will also be regularly reporting our progress over the next 12 months.

Right to left: Monkbar Pharmacy’s Paul Brett, Vikki Furneaux and Neil Withycombe

Join NPA members Paul Brett and Vikki Furneaux as they embark on their ‘Primary Care Network journey’. They will be providing regular updates over the next year about their progress engaging with their PCN in Yorkshire. Learning from their experience, your own PCN journey may be made easier.

Scotland won’t sit on its pharmacy laurels

By Phil Galt, NPA board member

Scotland is a good news story for community pharmacy and we’ve seen many positive developments in pharmacy practice across the network here.

When the NPA board came to Edinburgh in May, to discuss the things that matter most to the association’s members in Scotland, I confess to feeling rather proud about Scottish pharmacy’s many achievements.

Chief Pharmaceutical Officer, Professor Rose Marie Parr, attended our meeting and was once again very clear that pharmacy is a key partner in delivering NHS care in the community. Rose Marie is a force for good in the health & social care system and we eagerly look forward to her joining the panel at the next NPA conference, in Manchester.

Community Pharmacy Scotland was represented by Matt Barclay, who also looked forward to a ‘bright future for community pharmacy in Scotland’ based on the shared vision encapsulated in the Achieving Excellence strategy and the CPS manifesto.

It’s sometimes said south of the border that Scotland is a model that others should follow – in terms of the far-sightedness of the agenda here and also the constructive tone in which discussions are typically conducted between government, NHS and the pharmacy sector.

Certainly some of the things pharmacy leaders hanker for in England are long established in Scotland – notably a clear and agreed vision for community pharmacy within the NHS. Scotland’s Achieving Excellence Strategy, and in particular the Pharmacy First concept, is very much in line with the NPA’s view of community pharmacies as people’s front door to health care and healthy living.

Meanwhile, the constructive spirit in which recent talks about funding have been conducted is to be applauded.

All this hasn’t come easy, it hasn’t come quick and it mustn’t be taken for granted.

The Scottish Government, Community Pharmacy Scotland and others have worked hard at creating trust between them. There has been a stepwise approach to implementation of the service development programme. Vision has been backed up by resources and a sensible deployment of the levers available. It has taken years, not days and weeks to reach this position.

Not everything is in place.  For example IT connectivity, including access to patient records.  Furthermore, in Scotland we share many of the same challenges that pharmacies face across the UK – a tight public purse, ever increasing demand for health care, volatile supply and the uncertainties of Brexit and FMD. Pharmacies here, as much as elsewhere, are still too much at the mercy of factors beyond their control, such as medicines price hikes.

And in any event, we should see change and improvement as a never-ending duty upon us all.

So we can’t afford to rest on our laurels and the work continues.

Listen to what Matt Barclay had to say here:

Community pharmacy is in the vanguard of the prevention agenda

By Steve Brine, Minister for Primary Care and Public Health.

With all the recent talk around prevention in the health and care space, you’d be forgiven for thinking it’s being talked up as the newest kid on the block. In truth, we’ve known the ‘…better than cure’ truism for as long as medicine has been practised in civilised society.

As those of you working in – or with – community pharmacy know, prescribed medication is not all about treatment after the fact, it’s also about helping people manage existing conditions and mitigate or prevent more severe health issues developing in the future.

Prescribing, as a verb, is not even limited to pills, potions and lotions these days. Precede it with the word ‘social’ and you have a growing trend for GPs and other clinicians to recommend pool swims, Pilates and park runs as much as tablets, tinctures and tonics. Community pharmacists are likewise increasingly empowered to give advice across a wide range of common illnesses.

So, perhaps it would be better to say that – as we seek long term solutions to creating a sustainable health and care system – prevention’s time has truly come; and in our villages, towns and cities, community pharmacists and general practices are its vanguards.

That’s why the launch of Health and Social Care Secretary Matt Hancock’s ‘Prevention Vision: Prevention is better than cure’ has filled me with so much enthusiasm, excitement and hope for what can be achieved in our communities to support a growing, ageing and increasingly complex population.

Meanwhile, the Prime Minister’s recent announcement of a £3.5 billion a year funding boost for primary and community healthcare by 2023/4, is another welcome shot in the arm for the prevention agenda.

Of course, the Government is already encouraging local pharmacies to play a more significant role in helping people stay well in the community. Part of this involves an important shift in emphasis towards dispensing health and wellbeing advice, not just prescriptions and pamphlets.

To this end, there are already almost 9,500 community pharmacies registered as Healthy Living Pharmacies in England. Their staff deliver a wide range of lifestyle and health interventions, and promote wellbeing and self-care services.

Now, what interests me particularly about this initiative is the greater prevalence of community pharmacies in some of the most deprived areas of our country.

Anyone who knows me well will know my passion for early diagnoses, intervention and community outreach. This becomes of critical importance in these areas where a higher percentage of local populations haven’t registered with a GP. Sometimes, the community pharmacy is an individual’s only interaction with local health services – which makes it a potential gateway to the support and advice they need.

I am equally passionate about reducing health inequalities between the richest and poorest in society and doing what we can to realise the PM’s Ageing Society Grand Challenge of an extra five years of healthy, happy, independent living by 2035.

More broadly, in 2016, the Government committed to expanding the general practice workforce by an additional 5,000 doctors and another 5,000 practice staff (of which around 2,000 should be pharmacists by 2020).

An intended benefit of this expansion is greater collaborative working – within and between practices and community pharmacies.

There are already some great examples of this across the country.  I have nothing but praise for ‘Heartbeats on the high street’, which involves ten Essex based pharmacies joining forces to offer free blood pressure checks to test for high blood pressure and atrial fibrillation. As you know, the latter is a heart condition that significantly increases the risk of stroke and heart failure when undiagnosed. This is the prevention agenda in action. More schemes like this please!

Meanwhile, let’s not forget the other great work community pharmacies do to enhance the health and wellbeing of their local populations; from advice on sexual health, smoking cessation and healthy eating, to medicine consumption guidance, alcohol interventions and vaccination programmes.

On this latter point, in a very tough winter for flu globally, more than 14m people – an increase of almost 1.5m compared to the year before – have received their flu vaccines. Lives are being saved and community pharmacies deserve a large share of the credit.

Whether it’s something specific like flu vaccination or more general health advice, it’s abundantly clear that focusing more on prevention to stop or slow down future ill health can give people extra years of life, reduce premature deaths and mitigate long-term illnesses.

The upcoming NHS Long Term Plan provides a further opportunity to maximise efforts to improve health outcomes and reduce inequalities – and we must all grasp this opportunity.

This is not simply about cutting costs or saving money, but about improving quality of life and helping people lead healthy and happy lives alongside work, education and caring obligations.

Spending more money doesn’t necessarily improve outcomes but what we do spend it on matters a lot. When it comes to investing in community health services, like our pharmacies, I’d say that’s money well spent.

 

Steve Brine MP

 

Ask Your Pharmacist Week – a patient’s perspective

Graham Prestwich
Public and Patient Engagement Lead
Yorkshire & Humber Academic Health Science Network

A GP told me a couple of weeks ago that, in his view, not achieving safe and proper use of medicines is the biggest risk to effective care and the future of the NHS. Why? Something that is so common and so widely used, the most common approach to improving health and wellbeing, is not being used as intended or expected.

 

It is generally accepted that up to 50% of prescription medicines may not be used properly, even though many medicines are intended to prevent harmful and often fatal events such as a stroke or heart attack. There are 1.3 million items prescribed every day across the NHS and the NHS relies on people to use and take their medicines as intended. If patients are not using medicines as intended problems with effectiveness, safety and waste of treatment are the result. These are all good reasons to seek out new and effective ways to further improve patient outcomes.

 

Patients are important members of the health and wellbeing team, not least because when it comes to medicines, people can choose what to do and what not to do, and when. We asked people from different communities across the city about the way they use medicines and interestingly they revealed very similar issues. Most people openly shared their experiences and stated that they often have unresolved issues relating to the choice or use of medicines, and because their issue is largely unresolved a range of unhelpful actions take place. Often this means simply not taking the medicines. The more medicines someone is prescribed the more likely there will be an issue to resolve.

 

People give many different reasons for not sharing the full story about how they take their medicines with their doctor, the most common being concern about the reaction when it is discovered that they are not following the directions, either accidentally or intentionally, so the situation gradually gets worse. This means that doctors and their patients are not working as effectively together as they could be to reach the best possible outcome of care. Patients are leaving a consultation with their doctor or leaving a brief conversation with the pharmacist or pharmacy technician without sharing their issue that needs to be resolved to become confident in their medicines. Leaving the consultation with the issue still in your pocket means nothing is sorted and the issues get more and more complicated, and more difficult to resolve

 

So, whilst doctors, nurses and pharmacists are clinical experts, patients (and their carers) are the expert when it comes to their own life and all the opportunities and challenges day to day living throws at us. As patients we take control for most of the time, taking medicines every day and organising our own routine and depending on the people around us to help establish a reliable approach to our medicines. To be in charge we need to understand enough to do medicines taking responsibility, properly. This means that if we have an issue or concern we need to get it sorted and to access the right professional help to get it sorted.

 

For patients, community pharmacy teams are a fantastic resource, an opportunity to be helped and supported to overcome barriers to safe and effective use of medicines, and the starting point is asking for some insight to deal with an unresolved issue. The local pharmacist is a great person to ask because they are usually easily accessible during daytime hours, they know a great deal about medicines, and if they cannot help they will be able to explain who the best person to speak to is. Patients have the job of taking the first step and sharing with someone in the know what the problem is, in other words what exactly needs to be sorted.  Once the problem is known and shared it is much easier to find and agree on a solution.

 

Me and My Medicines is a campaign to support and encourage patients to ask and clinicians to listen so that through working together a shared decision and solution to the problem can be found that works for everyone involved.  Sharing the responsibility and agreeing the way forward, together. To support and enable this approach there is the Medicines Communication Charter which patients have developed to encourage more effective ways of supporting people to get the most benefit from their medicines. www.meandmymedicines.org.uk for more information.

 

I am delighted to support the NPA’s Let’s Talk Medicines Safety initiative during Ask Your Pharmacist Week – the purpose of which shares many similarities with the aims of the Me + My Medicines campaign.

The team at Lincolnshire Co-op reveal why they’re taking part in Ask Your Pharmacist Week

Here at Lincolnshire Co-op, we’re gearing up for Ask Your Pharmacist Week which runs from November 5 to 12.

 

 

The AYP theme this year ‘let’s talk medicines safety’ really resonates for us because patient safety is at the centre of all we do and we pride ourselves on the quality of our conversations with patients. It’s important that patients feel able to ask our pharmacists anything at all about their medicines, health and wellbeing. In particular we want to promote joint decision-making – with patients and carers playing a more active role in their medication management and comfortable to raise any concerns they may have.

 

As well as the main aim of the campaign – improving safe medicines use amongst our patients – there are other benefits from taking part.

 

One of the outcomes we hope to see by taking part in AYP Week is an increased number of patients making good use of MURs and NMS in our pharmacies.  The calls to action go something like this:  If you have been newly prescribed a medicine by your doctor, talk with your local pharmacist to understand how it works in your body and how best to take it; if you have been taking the same medicines for a long time, talk with your pharmacist about whether they are still working to best effect; if you have recently been discharged from hospital, check your medicines with your local pharmacist, because errors sometimes happen when patients move between care settings.

 

A week is just a week of course, and at Lincolnshire Co-op we participate actively in public campaigns like this all year round to help care for the health and wellbeing of our communities.  It helps to constantly reinforce the message that community pharmacists are accessible and approachable medicine experts.

 

In addition to using the core materials provided by the NPA in promoting our services during AYP week, we are also creating our own videos, which explain what MURs are, and creating our own MUR and NMS leaflets and posters.

 

The NPA is making free of charge resources available to you, and they are easy to use, so check out www.npa.co.uk/ayp2018 and get involved!

Representing you through consultations

Helga Mangion, NPA Policy Manager

The consultations that the NPA deals with tend to come from policy makers who develop policies relating to community pharmacy and independent pharmacy sector. The consultations issued by the Department of Health and Social Care and the GPHC are absolutely key as they directly impact the way pharmacies function and the way pharmacists interact with patients.

The NPA also responds to consultations that affect community pharmacy as a consequence rather than directly. For example; community pharmacy provides many ill-health prevention services, such as smoking cessation, and these services are commissioned through local authorities. A year ago the NPA submitted evidence to a parliamentary enquiry regarding the public health department’s move to local government. This inflicted huge impact on community pharmacy as now many pharmacy services are commissioned differently. Public health itself then suffered a dramatic budget cut, which in turn affected the number of services being commissioned through community pharmacy.

The main challenge in dealing with consultations is working to extremely tight deadlines. Major consultations often allow 3 months, whereas some more specific areas may only grant a matter of weeks. In this time we are required to inform members about the consultation subject matter, gather opinions and collate them as a response. For this reason it is vital for NPA members to respond and provide their views on consultations in the time allocated, as it could have a big impact on the future of community pharmacy. Hearing from our members who are out there working and living the reality of community pharmacists is a valuable asset, particularly when consultations call for evidence.

As the NPA’s Policy Manager, I am the members’ voice. Together we can speak louder for community pharmacy and with the help of member contributions we can make a huge difference to our future. Responding to a consultation does not have to be a formal process, NPA members are encouraged to write to independentsvoice@npa.co.uk or simply pick up the phone and call 01727 858687 ​

 

PGD Vaccination Training with the NPA

On a typical NPA PGD vaccination training day, pharmacists will attend the training site either for a morning or afternoon session. Pharmacists will meet their trainer and other pharmacists receiving training for tea, coffee and refreshments before starting 3.5 hours of training. This training will see participants learn important vaccination techniques, basic life support and anaphylaxis training.

Practise equipment like mock epi-pens, dummies and plastic training pads are available for trainees to perfect their injection technique. NPA PGD training days now offer a paediatric element where members can practise all learned techniques on baby, child and adolescent sized dummies. All trainees are given handouts with key information from the day.

The interactive training period is followed by a Q&A session with the trainer. NPA training days see a maximum of 12 delegates per session, ensuring a personalised and intimate focus for each member from the trainer.

We have seen an increase in demand for NPA PGDs since the tightening of pharmacy funding. PGDs are a good revenue stream, and the more PGDs that pharmacies provide, for example flu, travel and oral vaccinations, the more income and in-store footfall they will see.

NPA PGD training is a service that is highly valued by our members. Some regular feedback received by the NPA is that trainers are always attentive, clear and engaging. The NPA has put on more training dates in the past year than ever before, with no signs of popularity waning. Our training has covered over 70 venues across the UK so far this year, not including the bespoke sessions that are held for large member groups. The NPA is by far the busiest PGD provider and we are always working hard to consistently deliver the best, most convenient vaccination training days.

All NPA PGD training days can be booked online through www.npa.co.uk/pgd

My proudest NHS moment

We are the heart and hands of the NHS in our neighbourhoods.

“A patient had nominated our pharmacy team as we had supported her mental health alongside our excellent clinical role caring for her physical ailment.

As a result of her condition,  she had lost her job , was getting  increasingly socially isolated with the risk of further deterioration in her mental wellbeing.

We had acted proactively, contacting her regularly ,  supporting  her to be  more resilient and socially engaged.

We were really genuinely surprised to be informed of our award.

No less so than because we only did what many other community pharmacies likewise do daily.

Community pharmacy is the most accessible NHS outpost, a place where physical , mental and social challenges affecting the health and wellbeing of our communities gets resolved.

We perform this role because of the brilliant vision that created the NHS , of which we are an integral part not an adjunct .

The challenges faced today are multifaceted , the impact of social care and mental health  on physical health focusing attention on why parity of attention and resources across all three is essential.

As our patients and many others across the country can attest, community pharmacy offers so much.

We are the heart and hands of the NHS in our neighbourhoods.”

Ade Williams, Superintendent Pharmacist at Bedminster Pharmacy in Bristol.

Additional reading:

“I’m part of the NHS, not just an accessory to it” -read Ade Williams’ feature from earlier this year

My proudest NHS moment

"Patients are often surprised when they find out that I can prescribe and that they don’t always have to wait to see a GP - surprised and often very relieved."

“I’ve had patients come to me in quite a lot of pain and discomfort and I can often see them, there and then, without the need for an appointment.

Technically there are only three drugs in the BNF that I cannot prescribe but the reality is I only prescribe in my areas of competence for acute uncomplicated conditions. It’s like an extension of the minor ailment service so it’s for things like impetigo, gout, UTIs, ear infections, eczema and dermatitis.

I had to do six months’ training, alongside work, which was funded by the CCG just as the prescribing budget itself is. The CCG examined the health profile in Barrow in Furness and the difficulty in recruiting GPs and funded me in a bid to improve access to prescribers.

It works, we get quite a lot of referrals from surgeries and other pharmacies as well as by word of mouth. Patients still have to be registered with a local GP so I can access their records on the shared care viewer, which is more detailed than a summary care record.

It means we can help share more of the burden on the NHS system and take pressure off GPs and A&E but it is also often far more convenient for the patients themselves.”

Paul Blake, Pharmacist in community centre on Walney Island in Barrow-in-Furness, Cumbria