I am a pharmacist who has worked in multiple areas of the field. I have covered dispensary, hospital, and the GP sector. I spent time to develop my physical health skills through working in the GP practice and participating I the primary care pathway training which covered many physical health ailments incl atrial fibrillation, asthma, and COPD. I have been working as a specialist mental health pharmacist on inpatient wards, and community teams. My most recent role was also a management role, whereby I was the local site lead for Park Royal Centre for MH. It was thoroughly enjoyable, and I covered the Trust Lead pharmacist role in Learning Disabilities. I developed my knowledge in this area, and most recently attended a LD conference.

No

It is a reliable agency, and I have had good experience working with the agents as an employer/client.

There was a staff member who experienced chest pain whilst working in the pharmacy office. It was very alarming, as she had started to become more unwell and clammy/feverish over the day. She was feeling dizzy, and fell to the floor. I sounded local site the panic alarm and called for help. I utilised my ILS skills as I could, and checked the staff member was breathing.

The duty doctor attended with multiple nurses. The staff member was taken to A&E, and requested I go with her as her manager. I ensured the workload was adequately covered, alerted the senior pharmacy team, and ensured that staff were aware of what to do in case of any other emergencies.

Post incident, the staff and I had a safety huddle to ensure everybody was okay, and mentally feeling psychologically safe. We discussed the process to remind everyone of the escalation processes, and I offered support via supervision to all my team, as these situations can be upsetting and overwhelming. The staff member was safe.

The Act defines and outlines the law around regulation for medicines and supply. Some parts of the Act were replaced by The Human Medicines Regulations 2012, however the Act is still in place.

The MA1968 defines the legal requirements for supply, manufacture of medicines and animal feeding stuffs. The act outlines the governance for medicines supply into 3 categories: POM, P, GSL medicines, and outlines which medications require a prescription to be able to make a legal supply.

Take a full patient history including diagnosis, current symptoms, medical history, and recent prescriptions, and consultations, and allergies.

Request for consent and document consent - check the patient record/SCR and check if this medication is new or historic, and for any recent consultations/letters

Check for indication and why this medication is being recommended

Check who is requesting the medication and why it has not been prescribed by the requestor

If this has been requested by GP, go back to GP to prescribe as I have not reviewed the patient

If in a hospital, and if it is an emergency medication - life threatening, the emergency box should contain any emergency medicines required.

I would ensure I continue to complete my role to the best of my ability. I would check in with my line manager to check that the relevant information or documentation was available to check the complaint and the facts. I would ensure that I continue to remain professional at all times.

I would make my agency aware. I would ensure that I would learn from the complaint if there was constructive feedback provided.

Clinical Governance is a framework that is designed to enhance patient care and safety, and ensure continuous improvement in safety standards in healthcare settings. It is the overarching idea that sets out standards for ensuring accountability and responsibility to continuously assess patient care. There are 7 pillars: clinical effectiveness and research, audit, risk management, education and training, pt and public involvement e.g. pt satisfaction questionnaires, using IT, staffing, and governance structures to ensure accountability.

I had a 78yr old patient in the Older Adults community setting who was diagnosed with paranoid schizophrenia, and Parkinson’s disease. Current treatment was aripiprazole. The idea medication for this patient was clozapine, however the patient’s family opposed this medicine, and stated they do not wish for pt to be on clozapine, and did not want her admitted to hospital. The closet medicine choice and first choice was Olanzapine. Pts family wanted pt to be prescribed cariprazine, and made a formal complaint to the Trust. The complaint suggested that the pt was not being treated with medication that is effective and that the clinical team should prescribe cariprazine.

Following the complaint, I compiled background research to answer the query. I sought information from research papers, and other trusts who are currently using cariprazine, and also the licensing specifications for the medicine. I looked up side effect profiles, for each medication - Olanzapine vs cariprazine. I compiled the response to the patient, and had this checked by the Chief Pharmacist. Further to this, I requested for the consultant to be an added respondee to the query.

The answer was clear that it was not in the patient’s best interest to start an unlicensed medicine in the her current state, and the family agreed to commence Olanzapine.