Clinical Governance in Community Pharmacy

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Clinical Governance in Community Pharmacy

• Kent and Medway Pharmaceutical Collaborative Team

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What is Clinical Governance?

•  .. a framework through which NHS organisations
  are accountable for continuously improving the
  quality of their services and safeguarding high
  standards of care by creating an environment in
  which excellence in clinical care will develop

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Clinical Governance for Community Pharmacy The
K M Model

• Key Area One pharmacy premises
• Key Area Two training of pharmacy staff
• Key Area Three CPD for pharmacists
• Key Area Four communication complaints
  procedures
• Key Area Five health promotion

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Accreditation Process

• Pharmacies apply for an accreditation visit
• undertaken at an agreed time
• voluntary
• Two accreditors
• One pharmacist through the Collaborative
• One PCT non-pharmacist
• Visits take approx. one hour
• Accreditation valid for two years

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Accreditation Process

• Checklist made available in advance
• expected standards and methods for checking are
  explicit
• Format of visit communicated at start of visit
• Visit is completely non confrontational
• Both professional and member of the public
  viewpoint
• Written evidence of compliance with the framework
  standards

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Key Area 1 Pharmacy Premises

• Standard 1 the dispensary, shop floor and all
  staff have a professional appearance
• Standard 2 the property should be kept in good
  order both externally and internally
• Standard 3 displays in both the shop interior
  and the windows should reflect a professional
  approach
• Standard 4 There should be good access for
  customers (incl. disabled) and floor areas within
  shop should be kept free of stock to allow access

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Premises cont.

• Standard 5 A suitably private area for
  consultations should be identified
• Standard 6 A notice board or similar must
  include info about complaints procedure, identify
  the full range of services provided by the
  contractor and the out of hours access to
  services
• Standard 7 Date checking procedures for all
  medicines and foods should be in operation
• Standard 8 An up to date procedure manual should
  be readily available on the premises.

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Key Area 2 Training of Pharmacy Staff

• All members of staff whose work regularly
  includes sale of pharmacy medicines should have
  completed, or be working towards completion of a
  course covering the knowledge syllabus of the
  chemist counter assistant unit of the NVQ level 2
  in retail operations or equivalent
• All members of staff who have completed course
  should participate in relevant continuing
  education

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Key Area 3 CPD

• All pharmacists will complete a minimum of 30
  hours of accredited CPD each year

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Key Area 4 Communications Complaints Procedures

• Standard 1 Documentary evidence of compliance
  with the NHS complaints procedures must be
  available.
• Standard 2 A notice on how complaints will be
  handled should be displayed in the pharmacy
• Standard 3Confidential records of complaints
  should be kept and reviewed regularly in order to
  ensure continuing improvement of services

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Key Area 5 Health Promotion

• Standard 1 each pharmacist must complete the
  CPPE distance learning course health promotion
  and health screening
• Standard 2 contractors to participate when
  appropriate in HA or PCT wide health promotion
  campaigns

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Health Promotion cont.

• Standard 3 pharmacists will hold in house
  training sessions for their medicine counter
  staff on health promotion campaigns being run by
  the contractor
• Standard 4 health promotion leaflets will be
  displayed in a suitable manner
• Standard 5 the pharmacist manager will meet with
  local surgery staff at least once a year to
  discuss issues of mutual interest

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Accreditation Process

• Successful visit
• Report prepared post
• Congratulatory letter confirming compliance with
  the standards
• Certificate prepared and signed on behalf of the
  Strategic HA and relevant PCT
• Certificate sent to pharmacy to display

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Accreditation Process

• Unsuccessful visit
• Report prepared post visit
• Sympathetic letter sent to Clinical Governance
  lead at the pharmacy, highlighting the shortfalls
  and presenting two options

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Accreditation Process

• Option 1
• Up to three months to rectify shortfall
• written or photographic evidence to be submitted
  to show evidence of compliance
• support offered
• Repeat visit made to pharmacy, if necessary

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Accreditation Process

• Option 2
• Request that case is referred to the Steering
  Group for arbitration
• Written submissions to the Steering Group within
  28 days to challenge any decision made
• Steering Group
• Will send decision to the pharmacy within 28 days
  of the decision being made

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Accreditation Process

• Steering Group comprises
• 2 PCT Clinical Governance facilitators
• 2 PCT Pharmaceutical Advisers
• 2 LPC representatives
• Patient forum representative
• 1 PCT Clinical Governance lead
• 1 PCT Prescribing Adviser
• voting members

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Accreditation Process

• Accreditation withdrawn if
• Clinical Governance pharmacist leaves or reduces
  their hours to less than three days/week
• Premises are relocated
• A serious complaint is upheld against the
  pharmacist/pharmacy

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Accredited Pharmacies to End January 2005
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Clinical Governance the New Pharmacy Contract

• Three stages of accreditation
• National standards
• Seven key components that contractors must
  achieve as part of Essential Services. Will be a
  baseline across Kent Medway
• Kent Medway standards
• Additional level that contractors must achieve
  to be eligible for PCT commissioned Enhanced
  Services
• Advisory standards
• Additional level of good practice

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The New Contract National Standards

• Resources and processes
• Processes for quality improvement
• Patient public involvement
• Clinical audit
• Risk management
• Clinical effectiveness programmes
• Staff focus
• Staffing and staff management
• Education, training and continuing professional
  and personal development
• Use of information
• Use of information to support clinical governance
  and health care delivery