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Inadequate staffing levels enter top 5 most common inspection failures

Counter in a pharmacy
Duncan Rudkin: GPhC will continue to monitor staffing levels closely

Inadequate staffing levels have for the first time entered the top five areas failed in pharmacy inspections, the General Pharmaceutical Council (GPhC) has revealed.

The GPhC’s standard of having “enough staff, suitably qualified and skilled, for the safe and effective provision of pharmacy services” was not met by 27 pharmacies between January and March 2018, the regulator said in council papers published earlier this month (June 7).

It was the joint-third most commonly failed standard among the 1,068 pharmacies inspected over this period. You can see all five of the top inspection issues below.

“Typical” staffing issues identified by GPhC inspectors included “inadequate staff numbers to cope with the workload; staffing levels not being adequately considered before taking on a new service; and inadequate provision to accommodate planned or unplanned absences”, the GPhC said.

“Small numbers involved”

In an exclusive interview with C+D last week (June 14), GPhC chief executive Duncan Rudkin said that while any standard not met during an inspection is “a concern”, “the numbers involved are relatively small”.

However, adequacy of staffing is a “live issue” and one the regulator is “continuing to monitor very closely”, he added.

Sharing details of closures

The GPhC noted in its council papers that its members recommended that pharmacies be prepared to share their staffing plans during inspections, including details of any occasions when premises had to be closed due to staffing issues.

Mr Rudkin said while it is a matter for the NHS in England, Wales and Scotland to “monitor contractual performance” – including pharmacy opening hours – there may be some “overlap” in situations where the pharmacy has closed for safety reasons.

Expect more concerns raised

On May 24, the GPhC received new legal powers to publish pharmacy inspection reports. As part of a 12-week consultation – which will close on August 9 – the regulator has proposed publishing the reports of individual pharmacies on a new website, as well as “examples [of pharmacies] that demonstrate both good or excellent practice…and examples where standards are not being met”.

Mr Rudkin told C+D that “it is a reasonable hypothesis” to assume that there will be a greater number of concerns raised as a result of inspection reports being made publicly available.

“It doesn’t necessarily follow that there are more problems in pharmacy,” he stressed. But as the GPhC “makes regulation more visible to the public…of course this will be associated with a spike or increase in complaints and concerns”.

Top five standards failed by pharmacies in January-March

  1. Medicines and medical devices are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorised access; supplied to the patient safely; and disposed of safely and securely (standard 4.3, failed by 45 pharmacies)
  2. The risks associated with providing pharmacy services are identified and managed (standard 1.1, failed by 38 pharmacies)
  3. There are enough staff, suitably qualified and skilled, for the safe and effective provision of the pharmacy services provided (standard 2.1, failed by 27 pharmacies)
  4. All necessary records for the safe provision of pharmacy services are kept and maintained (standard 1.6, failed by 27 pharmacies)
  5. Pharmacy services are managed and delivered safely and effectively (standard 4.2, failed by 26 pharmacies)

Source: GPhC council meeting, June 7

12 Comments
Question: 
Does your pharmacy have adequate staffing levels?

SIMON MEDLEY, Community pharmacist

great- will they tell the DoH to increase funding to pay for extra staff - i'm suprisd pharmacies can recruit anyone when wage expectation is going up, workload is going up, skillset required is going up- but renumeration has plummeted

Peter Sainsburys, Community pharmacist

In only a couple of years the minimum living wage in London will reach parity with the locum rate. But I'm sure there will still be loads of misinformed students signing up for the MPharm courses.

Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

One suggestion I've heard going around in to put into place a minimum required staffing hours based on prescription items dispensed on an average month with a few additional concepts attached to this core idea, such as requiring a second checker at a certain threshold.

Del Boy, GP

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CAPT FX, Locum pharmacist

I have always said the GPHC is led by management from MARS or Jupiter. How big Dunc can say staff issues are on this list for the first time is not only surprising but disappointing . Every day of my life staffing issues are at the centre of the distress, open conflict, racial slurs and resulting fitness to prosecute cases that Duncan so prides himself.
He is even doing an excellent misleading marketing job for the multiples. Staffing issues are not few but they happen every day. The fact is that Duncan and his pistoleros at the GPHC are always behind the rapidly changing community pharmacy landscape. I have reviewed the so called new legislation which he claims is meant to control or regulate Pharmacy owners. It's vague , rumbling and a defence of contractors. Any legislation that doesn't have penalties for transgression is a waste. This man has prosecuted more than 2000 Pharmacists since he came to power , yet he hasn't censured any multiple even for fatalities on their premises. Does he think putting up a Premier league table of his poorly thought and inadequate inspections will change opinions? A resounding no. Now he is an expect of preserving deniability. He is the man, he is the man , like they say in gangsta lingo. Cry the hallowed profession
Here is Duncans concept of inspection. They announced 8 weeks before the inspection and the clever contractor bussed staff from other branches and on the day we were overflowing with staff. Just after the inspection we were down to bare bones again. I find it so difficult to avoid thinking that Duncan is like an executive of the Pharmaceutical industry seconded to the GPHC, whose aim is to shoot down anything sensible.

Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

I'd be curious to see what kind of action plans were put in place for Pharmacies that had failed this standard. The expectation could be an interesting example.

Meera Sharma, Primary care pharmacist

Interesting - takes this long to reach an inspection add-in. Now what?? Tell them to recruit more staff and if they keep trying for months on end, what then? In the meantime, errors continue & FTP continues.

Adam Hall, Community pharmacist

I think that is avery good point - you want to receruit but can't - what then?

Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

I would imagine most would say it was unfair to penalize for things outside of their control...hmm, on one side would see a resurgence of locum dispensers being used out of a necessity in that situation?

Pharmacist 7, Community pharmacist

This is exactly why the multiples should be made to follow the PDA’s Safer Pharmacies Charter. It’s about time the GPhC put fines or sanctions on the multiples who do not provide adequate staffing. It’s not safe!! How many times are we hearing this and nothing is being done by the GPhC?

Adam Hall, Community pharmacist

Don't think the report mentions anything about it being multiples that are the main culprits.

Peter Sainsburys, Community pharmacist

Yes, but we all know what the multiples are doing.

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