Accredited Checking Technician (ACT) Standard Operating Procedures

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1 Accredited Checking Technician (ACT) Standard Operating Procedures Standard Operating Procedures (SOP) 09/07

2 Standard Operating Procedures: For use in a pharmacy with an ACT (Accredited Checking Technician) This system is designed to allow suitably qualified staff to take on the role of Accredited Checking Technicians (ACTs). ACTs will, after full and thorough training be allowed to take on the final checking role providing a prescription has been subject to a full pharmaceutical assessment by a pharmacist. This pharmaceutical assessment will allow the pharmacist to approve the prescriptions to be checked by the ACT. This will allow the pharmacist to spend more time with problematic prescriptions or with customers themselves discussing any issues they may have with their medication. In addition to this, pharmacists operating with an ACT will be able to deliver effective professional services as required by Lloydspharmacy and the pharmacy contract. Dispensing and Accuracy Checking Procedure: 1 General Principles 1.1 All employees within the pharmacy must be fully aware of and work in accordance with these procedures. 1.2 If there is a failure to follow these procedures the company may take the decision to invoke disciplinary action. 1.3 Employees must be vigilant to identify prescriptions that may be forgeries. 1.4 ACTs must work under the supervision of a pharmacist at all times. It is essential that a pharmacist is always available to deal with any issues or matters of concern that may arise during the dispensing process. The pharmacist will make the final decision in these situations. 1.5 There are 3 main procedures to be considered when operating with ACT: A pharmaceutical assessment by a pharmacist to assess the prescription for legal/prescribing errors, accuracy of dose, drug interactions and any other unusual or additional requirements An accuracy check, which can be made by either the pharmacist on all prescriptions or the ACT on prescriptions that have previously been subject to a pharmaceutical assessment by the pharmacist on duty and duly authorised for the ACT to deal with Pharmacist intervention if the pharmacist intervention box of the ACT stamp has been signed the ACT must inform the pharmacist on duty when the prescription is ready for collection by the customer. The pharmacist who carries out the pharmaceutical assessment may intervene in the process at any point to ensure that all procedures are being fully complied with. 1.6 It is the professional responsibility of the pharmacist on duty to ensure that any amendments to prescriptions which are made during the pharmaceutical assessment are clearly annotated. The ACTs must be made fully aware of the amendments. 1.7 On completion of the pharmaceutical assessment the pharmacist must sign the pharmaceutical assessment box of the ACT stamp. If the pharmacist wishes to review the prescription on completion of the accuracy check, then it is their responsibility to sign the pharmacist intervention box of the ACT stamp. The ACT has a responsibility to ensure the pharmaceutical assessment box of ACT Stamp has been signed before the accuracy check commences. 2 Pharmacy Training Unit

3 1.8 On completion of the accuracy check, the ACT must sign the ACT/Final check box of the ACT Stamp. ACT Stamps are ordered for each pharmacy by the Support Staff Co-ordinator before training commences. If additional ACT Stamps are required for relief ACTs then it is their responsibility to inform the Support Staff Co-ordinator directly. Example of ACT stamp. LLOYDS PHARMACY 54 High Street, Keynsham, Bristol Telephone (01179) PHARMACEUTICAL ASSESSMENT ACT/FINAL CHECK PHARMACIST INTERVENTION 1.9 As a minimum, the pharmacist is recommended to make at least 3 random checks at different stages of the ACT process on a daily basis.the outcomes of the random checks should be documented and discussed by the pharmacist and ACT on a regular basis. This ensures every effort is being made to reduce potential risks to customers and to improve all standards within the dispensing process at all times. 2 Additions to the ACT SOP 2.1 The ACT SOP does not authorise the ACT to automatically perform the final check on the following: Controlled Drugs schedules Cytotoxics Extemporaneously dispensed products 2.2 If any of the above are to be included as part of the ACT SOP then the regular pharmacist must complete the form at the back of the document entitled Additional drugs/medicines to be checked by the ACT giving details of the name and drug that will be checked by the ACT as agreed by the regular pharmacist. Note. If all CD schedule 4 and 5 drugs are to be checked by the ACT then there is no need to list each individual drug tick the boxes at the bottom of the form. 2.3 This form must be sent with the Record of Competence form (see back of booklet). The Record of Competence form indicates that every member of the pharmacy team (not only the dispensary team) have read the ACT SOP and understand the roles and responsibilities of the ACT together with the practical implications within the workplace. Note.The forms must be faxed to the Support Staff Programme Manager: The practical element cannot commence until these forms have been received by the Pharmacy Training Unit. Pharmacy Training Unit 3

4 Note.The forms will be checked by the Support Staff Programme Manager and the Superintendent Pharmacist to ensure the amendments made are suitable and acceptable to use in Lloydspharmacy. 3 The Dispensary SOPs When a Lloydspharmacy is operating with an ACT, the ACT SOP supersedes the Dispensary SOPs. However, it is important that the Dispensary SOPs are read, understood and adhered to by all members of the team.this must be declared on the Record of Competence form. The following SOPs (updated May 2007) must be referred to at all times: Prescription Reception Prescription Reception Paid Prescriptions Prescription Reception Docket Procedure Pharmaceutical Assessment Interventions and Problem Solving (1) Prescriber SOP Interventions and Problem Solving (2) Customer SOP Labelling Assembly Owings (1) IPSS Owings (2) Owings (2) IPSS Accuracy Check (1) Accuracy Check (2) Accuracy Check (2) IPSS Note. Dispensary SOPs are updated regularly. Please ensure these are reviewed regularly. 4 Good Practice Guidelines 4.1 Labelling requirements / standards It is recommended that pharmacists do not utilise labelling as a tool to carry out the pharmaceutical assessment. It is important that labellers are competent and understand the information that must be brought to the attention to the pharmacist. 4 Pharmacy Training Unit

5 For example, whoever is labelling must highlight against the prescription in the following way: I = Interaction N = New drug = increased dose = decreased dose The ACT must be aware that if they receive a prescription annotated with any one of the above symbols, it is their responsibility to inform the pharmacist before the prescription is ready for collection by the customer If the customer already has a patient medication record, previous medication details on the medication record should be studied in order to check that there has been no change to the strength or dose of the customer s medication. Any changes should be brought to the attention of the pharmacist. 4.2 Accuracy Check Procedure When carrying out the final accuracy check the mnemonic HELP may be of use: H = Check How much has been ordered and supplied E = Check Expiry dates L = Check prescription against the Label of the dispensed medicine in particular the name of customer; name of product and the dose P = Check original Prescription against the product and original container 5 Relief ACT Procedure 5.1 On completion of a successful assessment and probationary period, the qualified ACT is accredited to the Lloydspharmacy ACT pharmacy in which the ACT training has been completed. 5.2 The ACT must fax a copy of the Training Record to the Support Staff Co-ordinator to receive the ACT Certificate. 5.3 If a qualified ACT is required to be accredited to work as an ACT in a number of Lloydspharmacy ACT pharmacies, it is the responsibility of the regular pharmacist(s) in the particular pharmacy to assess and declare the competence of the individual ACT(s). 5.4 Relief ACTs may only operate in 1 area only. 5.5 Relief ACTs may operate in the following ways: ACT required to work in Lloydspharmacy already with pharmacist known to ACT/Pharmacy operating with an ACT ACT required to work in Lloydspharmacy operating with a pharmacist known to the ACT/pharmacy not operating with ACT. Pharmacy Training Unit 5

6 Competence must be assessed as follows: - contact PTU - probationary period on 1 week - collect 50 items - feedback from existing pharmacist - observation of ACT in practice - ACT to go through ACT SOP with every member of the team - fax Relief ACT Training Record to the PTU - obtain ACT certificate for accreditation to that pharmacy ACT required to work in Lloydspharmacy with no regular pharmacist/pharmacy not operating with ACT ACT required to work in Lloydspharmacy with pharmacist not known to ACT/pharmacy operating with ACT. Competence must be assessed as follows: - contact PTU - probationary period on 1 week - collect 250 items - feedback from existing pharmacist - observation of ACT in practice - ACT to go through ACT SOP with every member of the team - fax Relief ACT Training Record to the PTU - obtain ACT certificate for accreditation to that pharmacy 5.6 It is the responsibility of the qualified ACT to inform the Support Staff Co-ordinator and obtain the following: The ACT Stamp for each pharmacy accredited to The ACT SOP to each pharmacy accredited to Obtain the Relief ACT Training Record Obtain the Relief ACT log sheets 5.7 It is the responsibility of the qualified ACT to discuss the role and responsibilities with the pharmacist(s) to ensure they fully understand the process. 5.8 On successful completion of the probationary period the Relief ACT Declaration of Competence must be completed and faxed to the Support Staff Co-ordinator. 5.9 The Relief ACT log sheets must be kept in the ACT Folder The Support Staff Co-ordinator will send copies of the ACT certificate to the accredited pharmacies Re-accreditation of the qualification will be required every 2 years. Support Staff Co-ordinator: Pharmacy Training Unit fax no: Pharmacy Training Unit

7 RECORD OF COMPETENCE FORM All members of the team have read and understood the ACT and Dispensary SOPs Please apply Pharmacy Stamp here Name Position Signature Initials Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 8 Pharmacy Training Unit

8 RECORD OF COMPETENCE FORM All members of the team have read and understood the ACT and Dispensary SOPs Please apply Pharmacy Stamp here Name Position Signature Initials Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 10 Pharmacy Training Unit

9 RECORD OF COMPETENCE FORM All members of the team have read and understood the ACT and Dispensary SOPs Please apply Pharmacy Stamp here Name Position Signature Initials To remain in pharmacy with SOP s 12 Pharmacy Training Unit

10 RECORD OF COMPETENCE FORM All members of the team have read and understood the ACT and Dispensary SOPs Please apply Pharmacy Stamp here Name Position Signature Initials To remain in pharmacy with SOP s 14 Pharmacy Training Unit

11 ADDITIONAL DRUGS/ MEDICINES TO BE CHECKED BY ACT Please apply Pharmacy Stamp here To be completed by regular pharmacist:- Drug/ Medicine Name Class of Drug/ Medicine Schedule 4 CDs to be checked Schedule 5 CDs to be checked Print name Sign name Registration number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 16 Pharmacy Training Unit

12 ADDITIONAL DRUGS/ MEDICINES TO BE CHECKED BY ACT Please apply Pharmacy Stamp here To be completed by regular pharmacist:- Drug/ Medicine Name Class of Drug/ Medicine Schedule 4 CDs to be checked Schedule 5 CDs to be checked Print name Sign name Registration number Please keep in ACT folder 18 Pharmacy Training Unit

13 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 20 Pharmacy Training Unit

14 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 22 Pharmacy Training Unit

15 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 24 Pharmacy Training Unit

16 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 26 Pharmacy Training Unit

17 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number Please return to: Support Staff Programme Manager Pharmacy Training Unit Sapphire Court Walsgrave Triangle Coventry CV2 2TX 28 Pharmacy Training Unit

18 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number To remain in pharmacy with SOPs 30 Pharmacy Training Unit

19 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number To remain in pharmacy with SOPs 32 Pharmacy Training Unit

20 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number To remain in pharmacy with SOPs 34 Pharmacy Training Unit

21 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number To remain in pharmacy with SOPs 36 Pharmacy Training Unit

22 For relief ACTs only: Declaration of Competence To be completed by regular pharmacist:- Pharmacy Number Pharmacy Stamp I declare that is competent to work as an ACT in the above pharmacy under my supervision. Print name Sign name Registration Number To remain in pharmacy with SOPs 38 Pharmacy Training Unit

23 Lloydspharmacy Relief ACT Training Record To be filled in for each additional branch ACT s Name (Block capitals):... Branch No:... Area:... Region:... Date Regular Pharmacist s Signature 1. Please state number of items checked during 1 week probationery period: items 2. ACT has been observed in practice and deemed satisfactory 3. Feedback has neen received by ACT s current regular pharmacist 4. ACT has given all staff an overview of ACT SOP s (where they are not currently in place) 5. ACT SOPs have been read and signed by all members of staff (including ACT and Pharmacist) Trainee s Signature:... Regular Pharmacist s signature:... Date:... Please fax this completed form to Office Use only Certificate produced and sent by: Signature: Date: Pharmacy Training Unit 39

24 Lloydspharmacy Relief ACT Training Record To be filled in for each additional branch ACT s Name (Block capitals):... Branch No:... Area:... Region:... Date Regular Pharmacist s Signature 1. Please state number of items checked during 1 week probationery period: items 2. ACT has been observed in practice and deemed satisfactory 3. Feedback has neen received by ACT s current regular pharmacist 4. ACT has given all staff an overview of ACT SOP s (where they are not currently in place) 5. ACT SOPs have been read and signed by all members of staff (including ACT and Pharmacist) Trainee s Signature:... Regular Pharmacist s signature:... Date:... Please fax this completed form to Office Use only Certificate produced and sent by: Signature: Date: Pharmacy Training Unit 41

25 Lloydspharmacy Relief ACT Training Record To be filled in for each additional branch ACT s Name (Block capitals):... Branch No:... Area:... Region:... Date Regular Pharmacist s Signature 1. Please state number of items checked during 1 week probationery period: items 2. ACT has been observed in practice and deemed satisfactory 3. Feedback has neen received by ACT s current regular pharmacist 4. ACT has given all staff an overview of ACT SOP s (where they are not currently in place) 5. ACT SOPs have been read and signed by all members of staff (including ACT and Pharmacist) Trainee s Signature:... Regular Pharmacist s signature:... Date:... Please fax this completed form to Office Use only Certificate produced and sent by: Signature: Date: Pharmacy Training Unit 43

26 Lloydspharmacy Relief ACT Training Record To be filled in for each additional branch ACT s Name (Block capitals):... Branch No:... Area:... Region:... Date Regular Pharmacist s Signature 1. Please state number of items checked during 1 week probationery period: items 2. ACT has been observed in practice and deemed satisfactory 3. Feedback has neen received by ACT s current regular pharmacist 4. ACT has given all staff an overview of ACT SOP s (where they are not currently in place) 5. ACT SOPs have been read and signed by all members of staff (including ACT and Pharmacist) Trainee s Signature:... Regular Pharmacist s signature:... Date:... Please fax this completed form to Office Use only Certificate produced and sent by: Signature: Date: Pharmacy Training Unit 45

27 Notes 46 Pharmacy Services

28 Notes 47 Pharmacy Services

29 Lloyds Pharmacy Limited Coventry CV2 2TX Tel: Fax: /07

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