I have been working as band 6 pharmacist at Royal Bolton Hospital and once I completed the 1st year of my clinical diploma and after a successful interview I started to work as band 7-audit and clinical pharmacist at RBH. From November 2022 when I decided to leave my band 7 clinical pharmacist role,I have been working a locum pharmacist in community.

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great and interesting job offers + competent staff in terms of negotiating shifts and rates + competent staff with regards to legislation around work permit for non British citizens

The most recent example would be a regular locum shift in a very busy community pharmacy with over 14000 items per month. The workload had already increased due to getting close to Christmass and new year bank holidays ahead; plus a few staffs were off sick. These 2 factors caused a backlog of all duties and consequently the waiting time for a prescription increased to 30-40 minute resulting in more distress for both patients and the staff. As the RP (despite being a locum), I had to re-assign pharmacy staff in order to reduce waiting time and speed up the process in a safe and effective manner. One person patients/customers who were there to buy OTC or collect medications which were already ready for collection (received text messages). Two other member of team were serving the queue of patients who were at the pharmacy for a new acute prescription to be dispensed and then collected. That decision helped to reduce the waiting time to maximum 5 minutes for purchase or collection of ready on shelf medications and 15-20 minutes for acute prescription or not ready repeats to be dispensed.

It is related to manufacturing and supply of medication and part of legislations and obligations for medicine safety.

First of all I am not a prescriber. But even if I was an NMP, I would have wanted to see the bigger picture:
1) Who is asking me to prescribe? e.g. patient? patient's advocate or carer? the nurse looking after the patient? ward doctor? the GP?
2) Is this a regular home medication which has been missed out on drug history done by a junior doctor on admission? If yes, is there any other notes and lab results available? e.g. patient has been on a list of medications including a PPI prior to admission. The initial admission doctor's note indicates that patient has got diarrhoea (one of presenting complains) and lab results show low Mg and Na level + patient has been taking the PPI not for an active ulcer but due to being on Alendronic acid which is held at the moment => hyponatraemia + hypomagnesaemia + loose stools + holding Alendronic acid can be the reasons for not prescribing the PPI this admission even though doctor has not documented this reason. So, restarting it without doctors approval would clinically be wrong and may harm the patient. However, as the pharmacists we can document the facts and rational for not prescribing the PPI on medicine reconciliation document and patient's note throughout admission.
3) There is no exact answer to this question unless we have a proper scenario in hand to discuss. But there is one rule of thumb: work within your competency. Do not restart even Adcal Caplets if you are not sure why it has been missed out on admission. Gathering enough information and having productive discussion with doctors can be really helpful to understand the situation that we are not sure about.

I will complete the online incident report system used by the trust. The relevant officer (medicine safety pharmacist) will investigate the incident further and guide you through the steps you may need to take. But if the incident is at alarming level e.g. resulted in patient harm I would personally prefer to speak with my line manager, medicine safety pharmacist ASAP alongside reporting it via DATIX.

The NHS organisations are responsible for assuring continuity in excellence in clinical care by improving and safeguarding the quality of care. This is done through regular intensive audits and monitoring (usually each quarter).

A mother called the pharmacy at 17:55 (5min to closing time) informing us that she will be at the pharmacy in the next 10 minutes to collect the 2nd bottle of her child's oral antibiotic. She was panicking and asking us to keep the pharmacy open for a little bit longer. Considering the fact that pharmacy has been opened since 8am in the morning giving enough time and opportunity to the parents to collect any medication on the day or day before patient was due for the next dose plus the fact that pharmacy is contracted for the certain amount of time to be open I had to reject the request. However, I did not want to delay any doses of treatment; therefore, I explained to the mother not to panic and try to get to the pharmacy by 18:00 then I could stay a little bit longer whilst preparing the antibiotic. If not possible to get safely to the pharmacy by 18:00, then they can contact NHS 111 for a referral to out of hours services for a new prescription to complete the course. I suggested to have all evidences such as empty bottle of 1st part of treatment in hand if needed. Although it was not an ideal outcome as the mother expected but at the end she knew in order to keep the business running I may need the superintendent pharmacist's permission + it has been her responsibility to ensure she will collect the 2nd part of treatment throughout the 10 hours opening time of the pharmacy on the day or day before due dose. She appreciated the extra information on how to obtain a new Rx out of hours as a matter of emergency.