Individual Supply of Patients’ Medicines
Accredited Programme
for
Pharmacy Technicians
N. Ireland
1
Regional Individual Supply of Patients’ Medicines Accredited Programme
Content
1. Introduction
Page number
3
2. Individual Supply of Patients’ Medicines Accredited
Programme
3
2.1 Aim
2.2 Candidate entry criteria
3
4
2.2.1 Essential entry criteria
2.2.2 Desirable entry criteria
4
4
2.3 Mentor criteria
2.4 Skills development throughout the programme
4
4
2.5 Responsibilities throughout the programme
2.5.1.1 Responsibilities of NICPLD
2.5.1.2 Responsibilities of the Trust
2.5.1.3 Responsibilities of the Mentor
2.5.1.4 Responsibilities of the Candidate
2.6 Programme overview and format
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Overview of the programme (flow diagram)
2.6.1 Pre-course work
2.6.2 Workshop
2.6.3 In-house interviews
2.6.4 Observations of supply and log of items
2.6.5 Final appraisal
2.6.6 Appeal
2.6.7 Accreditation
2.6.8 Reaccreditation
2.7 Periods of absence
2.8 Change of Trust for a drug history taking pharmacy
technician
2.9 Evaluation of the programme
3
Contact details
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9 & 10
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12
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Appendix 1
Range of errors
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Appendix 2
Terminology used in this document
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1.
Introduction
‘Medicines Management in hospitals encompasses the entire way that medicines are
selected, procured, delivered, prescribed, administered and reviewed to optimise the
contribution that medicines make to producing informed and desired outcomes of
patient care.’
Audit Commission, 2001
This Individual Supply of Patients’ Medicines (ISPM) Accredited Programme has
been requested by the Clinical Lead Pharmacists to standardise and accredit the
task of pharmacy technicians ordering?(supplying) patient’s medicines within the
hospital setting. This programme therefore continues to support the role of
pharmacists on the wards and ensures that skill mix within the ward setting is
optimised. All Lead Medicines Management Pharmacists within each Trust in
Northern Ireland have been involved in the consultation of this programme which has
been supported by all Trust Pharmacy Managers.
The programme conforms to the National Framework for Medicines Management
Pharmacy Technicians who are currently working in the United Kingdom (UK).
Individual Supply of Patients’ Medicines Accredited Programme
2.
Within the Trusts in Northern Ireland (NI) a range of systems are in operation to
facilitate the individual supply of patients’ medicines. This accreditation is designed
to encompass and accredit all of these systems, including: ordering, dispensing, final
checking and individual supply of medicines to a patient.
2.1
Aim
The aim of the ISPM programme is to:

provide pharmacy technicians in NI with a regional programme for an
accreditation which recognise the Individual Supply of Patients’ Own
Medicines and conforms to the National Framework for Medicines
Management Pharmacy Technicians

ensure that all pharmacy technicians are delivering the same level of service
to patients regardless of the method of delivery or the process used to order,
dispense, final check and supply medicines

aid the development of professional relationships and interaction between
pharmacy technicians, pharmacists, patients, colleagues and health care
professionals within the ward setting

support appropriate skill-mix within pharmacy.
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2.2
Candidate entry criteria
2.2.1 Essential entry criteria for candidates
Pharmacy technicians in NI may apply to enrol on this programme if they meet the
following criteria:
 candidate is a qualified pharmacy technician
 candidate must be registered with NICPLD
 candidate must have at least three months of experience as a qualified
pharmacy technician working in NI in a hospital setting
 candidate has been involved in the delivery of a ward based role for a
minimum of three months
 candidate has identified a designated mentor who has supported their
application
 candidate agrees to work within the limitations and remit of their own ability
and has demonstrated that they know when to refer to their mentor for
guidance.
2.2.2 Desirable entry criteria for candidates
Further desirable entry criteria includes:
 candidate is an Accredited Checking Pharmacy Technician (ACPT)
 candidate is an Accredited Patients’ Own Drugs Checker (POD)
 candidate is an Accredited Drug History Taker (DHT)
2.3
Mentor criteria
The individuals nominated as mentors to pharmacy technicians undertaking the
ISPM programme, must fulfil the following criteria:
 must be a qualified and registered pharmacist
 must have experience of mentoring staff according to the specific requirement
of their Trust
 must be a Clinical Pharmacist within the Trust.
2.4
Skills development throughout the programme
This programme is designed to support the development of the specific skills
required of anyone involved in the individual supply of patients’ medicines.
Throughout the course of the programme, candidates should demonstrate improving
competence in the following areas:
•
•
•
•
•
•
effective communication skills
effective interpersonal skills
effective time management skills
effective problem solving skills
the ability to provide medicines related information
the ability to accurately transcribe legible information
4
•
an awareness of the issues relevant to working within a patient focused
environment
•
the ability to apply key clinical skills
•
the ability to comply with the NI Clinical Pharmacy Standards and local Trust
policy for the supply of individual patient’s medicines
•
the ability to operate within the remit of their job role
All of these skills will be assessed by the mentor or witness pharmacists during the
process of observations and reflection on the candidate’s log of supplied items.
Candidates must be deemed competence in all of these areas prior to completion of
the accreditation.
2.5
Responsibilities throughout the programme
During the course of the programme, NICPLD, the Trust, the mentor and the
candidate all have defined responsibilities to ensure that a supportive learning
environment is provided for the candidate and to facilitate the completion of the
accreditation.
2.5.1 Responsibility of NICPLD
The role of the Northern Ireland Centre for Pharmacy Learning and Development is
to provide and facilitate the appropriate training and learning opportunities for the
candidates and their mentors. NICPLD’s role is also to encourage and support, the
record keeping and the assessment processed associated with the programme. It is
the responsibility of NICPLD to ensure that the programme criteria are applied fairly,
equally and objectively to each candidate.
2.5.2 Responsibility of the Trust
Pharmacists have overall responsibility for the pharmaceutical services being
provided to patients with the Trust Pharmacy Manager having ultimate responsibility
for the quality of the service provided. It is the role of the Trust to ensure that
anyone involved in the delivery or implementation of this programme has the
required resources and support to successfully complete their role. Trusts are also
required to support all participants particularly with regard to ensuring equality and
diversity being maintained before, during and after training.
2.5.3 Responsibility of the mentor
Each nominated mentor must commit to:
 attending the mentor workshop for the ISPM programme at NICPLD
 fulfilling the role of the mentor as stated in the learning contract (ISPM 2)
 meeting regularly with their mentee to provide support, ensure development of
underpinning skills and offer guidance
 liaising with NICPLD to support the completion of the programme within the
one year time frame.
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2.5.4 Responsibility of the candidate
Pharmacy technicians are responsible for their own professional actions and must
work within their own Trust’s Standard Operating Procedures (SOPs). They should
also consult the Medicines Ethics and Practice Guide (2010) and the PSNI Code of
Ethics (2009) for guidance relating to professional conduct.
Candidates are also responsible for their own completion of the programme and for
maintaining and reviewing their accreditation. They should ensure that all evidence
submitted for this accreditation is valid and authentic and that they report for any
interviews or appraisals in a timely fashion.
2.6
Programme overview and format
To facilitate the development of the underpinning skills required for the delivery of
this service, this accredited programme consists of a number of elements including:






Pre-course work
Workshop
In-house interviews
Observations of supply of patients’ medicines and log of items
Portfolio review and final appraisal
Accreditation and reaccreditation
Each of these elements is demonstrated in the programme overview on page 7
(Diagram 1). All candidates are required to complete this programme in not less
than three months but within twelve months of the workshop date.
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Diagram 1
Individual Supply of Patients’ Medicines Accredited Programme
All candidates must apply on-line for the ISPM programme.
Once accepted may commence pre-course work.
Candidates must forward confirmation of completion of precourse work to NICPLD.
All candidates and mentors must attend the ISPM workshop.
Candidate completes first in-house interview, a record of which
must be sent to NICPLD (ISPM 5).
Candidate may start their portfolio of evidence which must be sent to NICPLD and includes:
 first log of 50 supplied items (ISPM 3)
 5 observations by mentor (ISPM 4)
 5 referrals (ISPM 8)
Upon completion of log of first 50 supplied items, the candidate has their second in-house interview,
a record of which is sent to NICPLD (ISPM 3).
If successful they may
proceed to final review
process.
Candidate proceeds to collect remaining
evidence which includes their log of 100
items, observations and referrals.
If unsuccessful they
must contact
NICPLD to discuss
remedial work
required to
undertake.
Candidate must then complete a reflection of the
programme (ISPM 9).
Candidate may apply for and attend
portfolio review and final appraisal with
in-house panel (ISPM 10)
Upon successful completion of portfolio review and final
appraisal, candidate must forward ISPM 12 to NICPLD
Candidate issued with certificate for 2 years.
Candidate to apply for reaccreditation before
two year expiry date.
Candidate will be reaccredited if they
successfully meet the criteria for reaccreditation
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2.6.1 Pre-course work
Pharmacy technicians wishing to register for this ISPM accreditation must initially
complete the online application form to secure a place on the programme. Once they
have received confirmation of a place, the candidate should commence the precourse work before the workshop date.
The pre-course work includes:
1) reading and agreeing to adhere to the learning contract (ISPM 2) and faxing
a copy to NIPCLD
2) reading the relevant SOPs used for ISPM within their Trust
3) liaising with the Clinical Lead from the Trust to decide on the range of supply
methods with which the candidate will be involved. This should be recorded
on ISPM1.
4) reviewing and describing how patient confidentiality is ensured
5) providing a up-to-date curriculum vitae (CV).
6) providing an up-to-date job description which details the extent of their
medicines management role.
All pre-course documentation must be signed by the mentor where appropriate and
stored in the candidate’s portfolio.
The learning contract (ISPM 2) and the application form (ISPM 1) must be submitted
to NICPLD two weeks prior to the workshop date. Failure to submit this paperwork
by the required date will result in the candidate being withdrawn from the
programme.
2.6.2 Workshop
Candidates are required to attend a half-day workshop at NICPLD and on
completion of this workshop you should be able to:
 understand the principles of individual supply of patients’ medicines
 define the role of the pharmacy technician and that of the pharmacist in
providing this service
 appreciate the consequences of errors when supplying medicines
 describe the importance of accurate ordering, dispensing, checking and
supply
 work within the requirements of the Trust’s SOPs for ISPM
 recognise the importance of patient consent and confidentiality
 refer appropriately when limits of authority have been reached
 accurately complete the documentation that has been developed to support
this programme.
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2.6.3 In-house interviews
During the course of the programme, candidates are required to have two in-house
interviews with their mentor. The first interview will take place having attended the
workshop and prior to commencing the log of supplied items. The second interview
will take place once the candidate has gathered a log of 50 supplied items and been
observed by their mentor undertaking this role on five occasions.
The purpose of these interviews is to ensure that the candidate is supported and that
they continue to make progress against the required competences. The in-house
interviews should be recorded using ISPM5 and ISPM7 and these should be faxed to
NICPLD and the originals stored in the candidate’s portfolio.
2.6.4 Observations of supply of patients’ medicines and log of items
Candidates are required to complete a log relating to the supply of 100 items (ISPM
3). All of these supplied items should be double checked by the mentor or witness
pharmacist. The candidate should make no errors in the supply of these items. If an
error does occur, the candidate should reflect upon the reasons for the error (ISPM
6) and undertake supplying an additional 100 items which should be logged on ISPM
3. Once again, the candidate should make no errors in the supply of these 100
items.
During the completion of this log, the mentor or witness pharmacist should
continually review the candidate’s portfolio and must observe the candidate’s
performance on five occasions. A record of this holistic observation should be made
(ISPM 4) and stored in the candidate’s portfolio. During the observations and on
reviewing the candidate’s portfolio, the mentor must ensure that the following criteria
are met.
2.6.4.1
Ensuring that all orders and supplied items are accurate
Candidates should refer to their Trust’s SOPs to ensure consistency in ordering the
correct item for individual patient supply. When ordering, candidates should ensure
that:
 all prescriptions or orders are valid, and are written clearly to avoid
misinterpretation
 the correct medicine brand has been ordered (if appropriate)
 the correct dosage and form has been ordered for the patient ensuring that
patients with any special requirements have been taken into consideration
 the correct strength has been ordered
 the correct quantity has been ordered
 the medicine is labelled correctly
 the correct instructions for administration are written clearly
 the Trust formulary has been adhered to
 the appropriate documentation has been submitted
 the appropriate cost centre has been charged with the appropriate code (if
applicable).
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2.6.4.2
The log reflects a range of supply methods
The following are examples of different types of supply that should be reflected in the
candidate’s log and portfolio:
 new medicine
 repeat medicine
 re-labelled medicine
 returned medicine no longer required
The supply may be generated for any of the following:
 one stop dispensing
 compliance aid dispensing
 inpatient supply
 dosette or MDS
 discharge or patient transfer.
Candidates are encouraged to check all possible locations for ‘lost medicines’ before
a repeat supply is ordered.
2.6.4.3
Orders are processed in a timely fashion
Candidates are required to demonstrate the ability to demonstrate the following
whilst generating a supply for an individual patients’ medicine:

all orders are generated and processed in a timely fashion

all patients receive the correct order within an appropriate time frame
 all patients are informed if there is a delay in the supply of their medication
and steps are taken to remedy this delay.

patient interaction is controlled by the candidate using open and closed
questioning techniques
2.6.4.4
Risks are identified, documented, solved or referred
Candidates are required to demonstrate the ability to identify risks and solve any
problems. When candidates encounter problems they are required to remedy them
if possible. If they are unable to remedy the issue personally, they must refer to an
appropriate person such as a more senior pharmacy technician or a pharmacist.
This referral should be documented using ISPM 8.
Such issues or problems that the candidate may encounter include::
 compliance issues
 identifying medicines that have been stored incorrectly e.g. fridge items or
CDs
 missed doses
 out of stock items
 non-formulary items
 manufacturing or supply problems.
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Candidates are also required to identify and resolve any discrepancies, such as:
 expired medicines
 excess medicines
 supply requirements
 returns/ non-stocks.
All candidates should refer to their Trust’s relevant SOPs to ensure they have
followed the correct procedure. If any changes to the SOPs are made, regarding
storage or disposal of the patients’ supply, it is the candidate’s responsibility to
ensure that new SOPs are followed and that they are fit for purpose. Candidates are
also required to ensure that SOPs for medicine alerts, withdrawal and incidents are
followed.
2.6.4.5
Documentation completion
Throughout the process candidates must ensure
completed accurately and in a timely fashion. All
that:

documentation for orders is clearly written
the appropriate ordering system for their Trust

records of supply are maintained where
prescription or order form.
that all relevant documentation is
candidates are required to ensure
and is legible and accurate using
appropriate, for example, with a
All candidates should refer to their Trust’s relevant SOPs to ensure they have
followed the correct procedure; if any changes to the SOPs are made it is the
candidate’s responsibility to ensure that new SOPs are followed and that they are fit
for purpose.
2.6.5
Final appraisal
On completion of the log of 100 supplied items, the five observations and the five
referrals, candidates should apply in-house for their final appraisal. This appraisal is
a three stage process and includes:
 a reflection on the candidate’s participation in all stages of the programme
 a review of their portfolio of evidence (refer to ISPM 10)
 a competence based interview (ISPM 11)
Candidates who meet the programme assessment criteria and successfully complete
the final appraisal will be informed of their success by a member of the interview
panel.
Candidates who do not successfully complete the final appraisal must discuss with
their Trust if a second attempt at the programme will be permitted. If permission is
granted, candidates must re-start the process from the beginning.
Following successful completion of all in-house components of the ISPM
programme, all candidates must submit their completed documentation to NICPLD.
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2.6.6 Appeal
NICPLD will treat all candidates fairly, equally and with respect in relation to any
assessment. If any candidate is dissatisfied with the outcome of their final appraisal
they must contact NICPLD within five working days and give notice of their
dissatisfaction and of their intent to forward an appeal. The formal appeal procedure
must then be followed:
1. All appeals against the conduct, adequacy or outcome of an assessment must be
forwarded in writing to NICPLD within 10 working days after the technician has
given notice of their intent.
2. On receipt of notification of an appeal, NICPLD will set a date for the appeal to be
heard (within 30 working days of receipt of the written notification of the appeal)
by an appeals panel. The appeals panel will consist of:
 A representative of NICPLD
 Medicines Management Lead or Clinical pharmacy manager not otherwise
involved in the appeal
 A pharmacy technician not involved in the appeal.
The candidate will be offered the opportunity to be accompanied by another person
not involved in their accreditation to help them present their case.
3. The appeals panel will reach a decision and all involved parties will receive
verbal notification the outcome on that day and written notification within 5 working
days. This decision will be final.
2.6.7
Accreditation
Successful candidates will receive an accreditation certificate that will be posted out
within 4 weeks of NICPLD receiving the final completion documentation (ISPM 12).
The certificate is valid for two years from the date of accreditation and it is the
responsibility of the candidate to ensure they are reaccredited before their certificate
expires.
2.6.8
Reaccreditation
It is the responsibility of all pharmacy technicians to gain reaccreditation before the
expiry of their certificate.
All candidates seeking to be re-accredited must forward:
 maintain an on-going log of any errors made relating to ISPM and document
these according to their department error recording policy
 reflect on any errors made and record, using ISPM 6 or, if a learning need is
identified, using a CPD cycle, a reflection.
These reflections should be
reviewed and discussed periodically with the mentor to ensure they are within
Trust error reporting limits
 provide documentation to confirm the opportunity to work within the scope of
the role on a regular basis, defined as at least two hours weekly (ISPM 13).
 provide evidence of an appraisal which has reviewed their role over the last
two years
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


2.7
a reflection of their own performance over the last two years
five referrals to an appropriate person
five reflections of problems or issues which have been resolved by the
candidate and endorsed as accurate by the candidate’s mentor.
Periods of absence
If a pharmacy technician is unable to work on a regular weekly basis supplying
individual patients’ medicines for a minimum of two hours per week it is
recommended that before re-commencing the delivery of this service they undertake
a review of the SOPs and re-familiarise themselves with the process.
If the pharmacy technician is absent from this role for a longer period of time, it is
recommended that they are undertake a log of supplied items as described in the
table below. All ISPM must be double checked by their mentor and documentation of
at least two observations of the candidate must be recorded using ISPM 4.
Period of absence
Required quantity of
supplied items
25
50
75
Must restart the
accreditation
< 6 months
6 – 12 months
≥ 12 months
≥ 24 months
Accredited ISPM pharmacy technicians and their mentors should conform to this
guidance relating to periods of absence. If any pharmacy technician is absent from
the supply role for two years they must re-start the process.
2.8
Change of Trust for an ISPM pharmacy technician
Prior to a pharmacy technician moving from one Trust to another it is the
responsibility of the technician to have their accreditation documentation validated by
their mentor before leaving their original Trust. The candidate is required to provide
their current valid certificate to their new employer.
A pharmacy technician who transfers from a hospital in Great Britain will have to
present their relevant certificates which must be endorsed by their mentor. It is the
Clinical Manager’s decision at each Trust to agree with the pharmacy technician the
amount of time required to re-train in their new and different environment. A three
month period of orientation at their new site would always be recommended.
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2.9
Evaluation of the programme
The evaluation of this programme is a three stage process:
 Workshop evaluation – the ISPM workshop is evaluated by all participants
using the standard NICPLD workshop evaluation form
 Programme evaluation by candidates – the candidates evaluation of the
programme is captured using the final reflection form (ISPM 9)
 Programme evaluation by experts – the programme is reviewed on an annual
basis by experts who are involved in the delivery of the training. The
recommendations of these individual are presented to the Regional Medicines
Management Lead Pharmacists group who will decide if any changes are
needed due to changes in service or its requirements.
3.
Contact at NICPLD
If you have any queries regarding this, or any of the training programmes offered for
pharmacy technicians through NICPLD, please contact:
Julie Jordan
Lead for Pharmacy Technician Training,
NICPLD
Riddel Hall,
185 Stranmillis Road
Belfast
BT9 5EE
Tel: 028 90974477
Fax: 02890974488
j.a.jordan@qub.ac.uk
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Appendix 1 - Range of errors
This list provides examples of error(s) which may be detected by the mentoring
pharmacist or witness pharmacist.
Types of errors
Wrong ward or department
Wrong patient name
Wrong medicines generic name
Wrong medicines brand name
Wrong medicine form
Wrong medicine strength or dose
Wrong frequency on directions
Incorrect duration
Non-formulary item with no supporting
documentation
Incorrect code for charging
Missing detail i.e. starts or stop dates
Expired item
Inappropriate referral
Lack of referral
Incomplete documentation or poorly written
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Appendix 2 - Terminology used in this document
NICPLD- Northern Ireland Centre for Pharmacy Learning and Development
ISPM-Individual Supply of Patient’s Medicines
CV-curriculum vitae
ACPT –accredited checking pharmacy technician
POD-patient’s own drugs
DHT- drug history taking
PSNI-Pharmaceutical Society for Northern Ireland
Mentor for ISPM-a pharmacist who has the relevant clinical experience
Witness pharmacist- a pharmacist who has been deemed fit to observe a candidate
undertaking the individual supply of patient’s medicines
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