Edited by Martin Stephens
BPharm, MSc, MRPharmS, MCPP Associate Medical Director, Clinical Effectiveness and Medicines Management Southampton University Hospitals NHS Trust
Published by Pharmaceutical Press 1 Lambeth High Street, London SE1 7JN, UK 1559 St. Paul Avenue, Gurnee, IL 60031, USA Ó Royal Pharmaceutical Society of Great Britain 2011 is a trade mark of Pharmaceutical Press Pharmaceutical Press is the publishing division of the Royal Pharmaceutical Society First edition published 2003 Second edition 2011 Typeset by Thomson Digital, Noida, India Printed in Great Britain by TJ International, Padstow, Cornwall ISBN 978 0 85369 900 2 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the copyright holder. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. The right of Martin Stephens to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act, 1988. A catalogue record for this book is available from the British Library.
Marjorie, thank you for your patient support.
Preface About the editor Contributors Abbreviations Introduction 1 Hospital pharmacy within the National Health Service Martin Stephens History Payment by results The Next Stage Review The NHS from 2010 Hospital pharmacy within the NHS The future References Further reading 2 Pharmacy in the acute independent sector Karen Harrowing Introduction Independent sector and the NHS – from concordat to free choice Plurality of provision and patient choice References Further reading 3 Purchasing medicines Howard Stokoe and Phil Deady Background Aims of the service How the service has developed Hospital procurement and the application of EU legislation
xv xvii xix xxiii xxvii 1 1 3 4 6 7 12 12 13 15 15 17 19 26 26 27 27 28 29 30
viii | Contents
Looking forward References Further reading 4 Medicines supply and automation Chris Green and Don Hughes History Current systems Storage arrangements Ordering ward stock Supply to outpatients New and emerging technologies References Further reading 5 Controlled drugs in hospital pharmacy Liz Mellor Background: legislative framework The accountable officer Standard operating procedures Routine monitoring and auditing Inspection, self-assessment and declaration to the relevant authority Collaboration and local intelligence networks Medicines management Conclusion References Further reading 6 Technical services Graham Sewell History Licensing issues Repackaging (prepacking, assembly) Non-sterile manufacture Sterile manufacture Aseptic preparation Intravenous additives Total parenteral nutrition Cytotoxics Radiopharmaceuticals Facilities and equipment
38 39 39 41 41 42 46 48 49 53 54 55 57 57 58 59 59 61 61 62 66 66 68 69 70 72 72 76 79 81 82 83 84 84 85
Contents | ix
Education and training for hospital technical services Health and safety and environmental issues The future Acknowledgement References Further reading 7 Quality assurance Ian M Beaumont The NHS quality agenda and the role of the quality assurance pharmacist Clinical governance Risk management Medication errors The aims of NHS pharmaceutical quality assurance services Development, issue, implementation and monitoring of standards and guidance Quality assurance and quality control of medicines The future References Further reading 8 Medicines information Peter Golightly and Christine Proudlove History Structure and activities Aims and strategy Roles and skills Ethics and legal issues Clinical governance and risk management Activities Support for decision-making...