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Concerns over "lack of prescribing data" in Hospital Pharmacy

Concerns over

Thursday 01 August 2024

Concerns over "lack of prescribing data" in Hospital Pharmacy

Thursday 01 August 2024


Unsafe or inappropriate prescribing in the Hospital Pharmacy cannot be easily identified due to a lack of data, according to a report outlining safety concerns in the Health Department.

A report shared with the Health Advisory Board last week revealed that there is currently no resource available to analyse and produce reports showing individual prescribing practice from the Electronic Prescribing Medication Administration (EPMA) system.

This system, introduced in May to replace paper prescriptions with electronic submissions, was intended to streamline processes, reduce queues, and minimise administrative errors.

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Pictured: The electronic prescribing system was introduced after many islanders took to social media to highlight Hospital pharmacy queues of up to two hours.

But a report by the Quality, Safety and Improvement Committee recently revealed that a lack of data analysis capabilities within the system means that individual prescribing practices cannot be effectively monitored or evaluated.

"Concerns remain regarding the lack of prescribing data"

The report said that "concerns remain regarding the lack of prescribing data to provide assurance regarding appropriate and safe prescribing".

Dame Clare Gerada DBE – Chair of the Quality, Safety and Improvement Committee and author of the report – explained that such data is crucial as a quality indicator.

Specifically, she said that this information would "ensure that systems and processes will direct prescribers to the safest practice and identify inappropriate prescribing".

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Pictured: An independent review team recently raised concerns about the lack of built-in challenge to prescribing by the Hospital Pharmacy team.

It comes less than a year after a damning review of Jersey's Rheumatology Department raised concerns about the lack of built-in challenge to prescribing, particularly regarding high-cost drugs, by the Hospital Pharmacy team.

The Royal College of Physicians' independent review team also raised concerns about the lack of requirement for prescriptions to include the clinical indications for treatment.

This meant that the Pharmacy Department had no checks in place to ensure compliance with guidance, nor was there challenge to advice given by consultants to patients on dosing.

As a result, a new pharmacist was appointed in February to specifically oversee the prescription of biologic drugs – the high-cost and powerful medication at the centre of the rheumatology review.

Health "must make things better for pharmacy staff"

Factors affecting recruitment and retention in the Hospital Pharmacy were also outlined elsewhere in notes presented to the Health Advisory Board last week.

These included flexible working arrangements, terms and conditions, and remuneration packages.

The report read: "Specifically, pharmacists are offered more money to work in GP [or] community pharmacy settings in Jersey."

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Pictured: Two HCS pharmacy jobs are currently being advertised on the Jersey Public Service Careers Portal.

Licensing restrictions also limit part-time working options across the Pharmacy Department, according to the report.

Despite these challenges, benchmarking data from similar healthcare jurisdictions suggests the Health Department is in a relatively "favourable position".

The Committee concluded: "Whilst accepting there are issues out with HCS's control, HCS must make things better for pharmacy staff in the organisation."

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Pictured: Three HCS pharmacy jobs were advertised on the Jersey Public Service Careers Portal in May – two of which are still being advertised three months later.

Currently, the public service careers website shows two open positions in the pharmacy: a Dispensary Clinical Pharmacist and a Senior Pharmacy Tech Medicine Management.

Both jobs were also being advertised on the portal in May.

The Quality, Safety and Improvement Committee has requested a follow-up report in six months to assess improvements made to the Hospital Pharmacy staffing situation.

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