NEWS
AFTER ALMOST FOUR YEARS OF WAITING, PHARMACISTS THROUGHOUT SCOTLAND – AND ACROSS THE UK – ARE NOW MOVING A STEP CLOSER TO HAVING A LEGAL DEFENCE FROM CRIMINAL SANCTIONS FOLLOWING AN INADVERTENT DISPENSING ERROR.
CAUTIOUS WELCOME FOR DISPENSING ERROR DEFENCE
The Pharmacy (Preparation and Dispensing Errors – Registered Pharmacies) Order 2018, which has now been laid before Parliament, follows work by the Department of Health’s DoH’s) pharmacy regulation ‘rebalancing’ board, led by Ken Jarrold.
For years now, pharmacists have gone about their daily business under the shadow of criminalisation should they commit a dispensing error, and the profession has long maintained that some form of legal ruling should be put in place to remove this ‘shadow’.
This new order includes new defences relating to preparation and dispensing of medicines by registered pharmacists, pharmacy technicians and ‘persons supervised by them’ at ‘retail pharmacy premises’.
In February 2015, the DoH issued a consultation document, which focused on decriminalising dispensing errors by providing pharmacists with a defence against criminal sanctions for dispensing errors made ‘inadvertently’. In February of last year, the Rebalancing Board published a report detailing the responses to the consultation but said at the time that a ‘separate report’ would be published on the responses to the consultation questions on the Pharmacy (Preparation and Dispensing Errors) Order 2016.
According to this new order, which was laid before Parliament by the DoH, a pharmacy professional or unregistered member of staff should have a defence against a criminal
6 - SCOTTISH PHARMACIST
sanction for an inadvertent dispensing error if they meet a set of conditions.
These conditions include:
• Showing that the pharmacist or technician had acted ‘in the course of their profession’.
• That they had sold or supplied a medicine on the back of a prescription or patient group directive and had ‘promptly’ informed the patient once the error was discovered.
Furthermore, the Order directs that criminal sanctions should only apply if there is proof ‘beyond reasonable doubt’ that the pharmacist either misused their professional skills for an ‘improper purpose’ or showed a ‘deliberate disregard for patient safety’.
The order comes almost a year to the day since Northern Ireland pharmacist, Martin White, received a four-month suspended prison sentence for a prescribing error. In November 2015, White inadvertently dispensed the wrong medication to a 68-year-old patient, Mrs Ethna Walsh. Instead of providing Mrs Walsh’s husband with prednisolone, White dispensed propranolol, which was positioned beside the prednisolone on the pharmacy shelf. Within a few hours of taking the wrong medication, Mrs Walsh tragically died.
In December of last year, Martin White was found guilty of ‘supplying a medicinal product in pursuance of a prescription given by a practitioner, which was not of the nature or
quality specified in the prescription’. As a result, he was sentenced to four months’ imprisonment, which was suspended for two years.
In September, the Pharmaceutical Society of Northern Ireland’s (PSNI) statutory committee’s hearing of the Martin White case was brought to an end, with the committee handing down a seven-month suspension to allow the pharmacist ‘sufficient time to consider the reasoning of the Committee’ while, at the same time, ‘ensuring that the public interest was protected’.
The Order has been welcomed by the pharmacy regulatory bodies – albeit somewhat guardedly.
Steve Howard, Quality & Clinical Standards Director and Superintendent Pharmacist at Celesio views it as a ‘milestone’.
‘I am delighted,’ he said, ‘to see that the Dispensing Errors Order 2018 has been laid before Parliament. This is a significant milestone and my thanks and congratulations go to Ken Jarrold and all the Rebalancing Board members and officials for their tenacity and determination to see this through. I am confident that this will be supported by improvements in reporting and learning, and such will enhance patient care.’
Matt Barclay, Director of Operations at Community Pharmacy Scotland (CPS), sees it as the next step in a continuing process.
‘While CPS is delighted to see this Order placed before Parliament,’ he
told SP, ‘we are fully cognisant of the fact that this is just ‘the next step’ in this process. There is still quite a bit to go to ensure that pharmacists can go about their daily work safe in the knowledge that they will not face prosecution for a dispensing error.’
The General Pharmaceutical Council believe that the change in legislation will remove a barrier to improved reporting and learning from errors.
‘We very much welcome the news that the Dispensing Errors (Registered Pharmacies) Order has now been laid before Parliament,’ said Duncan Rudkin, Chief Executive of the GPhC.
‘Openness and honesty when things go wrong is a core part of the standards for pharmacy professionals.
‘We look forward to a governmental consultation next year on removing the threat of criminal sanctions for dispensing errors made by pharmacists working in settings other than registered pharmacies. We have consistently been clear that single dispensing errors do not in our view constitute a fitness to practise concern, if there is not a wider pattern of errors or significant aggravating factors.’
As yet, no definite date has been given regarding when the amendments to the Medicines Act 1968 will come into force, with Parliament saying only that it will be on ‘such days as the Privy Council may by order appoint’.
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