The deadline for implementing the False Medicines Directive (FMD) is just over a year away and there is much to be done to ensure compliance for community pharmacy. Shanel Raichura, director of pharmacy at EMIS Health, explains…
Over 5,000 community pharmacists use our PMR, and EMIS Health has been a leading voice in the discussions on getting the right IT in place in time.
Our customers are acutely aware that the FMD will have a significant effect on the way they dispense medication. Technology will need to be smart and flexible to enable them to absorb the extra work involved in verifying and decommissioning drugs, while dispensing patients’ medication in a timely manner.
With the continuing squeeze on income, pharmacists simply do not have the resources to employ more staff to cope. The extra step of scanning each pack will significantly increase the time spent dispensing prescriptions.
There needs to be an overhaul of the standard operating procedures to accommodate this. Technology will do the heavy lifting. With the tight deadlines in mind, some pharmacists may opt for a standalone FMD system that is more readily available.
This would involve flipping to a separate application sitting outside the dispensing process. However, in my view, our customers need a solution that is integrated with their existing PMR. This is because:
• The PMR will trigger certain actions to comply with decommissioning through integrated functionality in the PMR.
• It will be more efficient, as the scanning of products will be streamlined into the PMR dispensing processes, to ensure pharmacists minimise the operational impact.
• The FMD will yield other benefits to pharmacy. The scanning functionality could allow pharmacy colleagues to improve their stock management, and enable safer dispensing by ensuring that the correct product is accurately picked every time.
• Community pharmacy requires integrated functionality that is flexible to enable scanning as close as possible to the handover of medication to the patient or their representative. If the decommissioning is done too early, then there is a risk the patient may not collect within 10 days, voiding the pack.
• The application has to be designed to cope with offline work, and therefore have the ability to ‘queue’ all packs scanned, and then transmit once the service to the national verification system has been restored.
While we are already scheduling in the development work for the integrated technology to support our customers, there remain a number of unanswered questions and potential risks on the road to smooth implementation.
There is no decision as yet on how the FMD functionality will work for an integrated system. For example, the technology has to be flexible to enable pharmacists to decommission medication as close as possible to dispensing, within a 10-day window.
But the UK FMD working group for community pharmacy is still considering the optimum point for decommissioning. We know that every pharmacy in Scotland and England will have to purchase multiple 2D scanners (or even wireless scanners) for each branch so that staff can efficiently verify drugs.
Wales and Northern Ireland already have these. Will funding for this be released in time for these to be integrated with PMRs to meet the deadline? We need guidance from pharmacy bodies on how the FMD will work with hub and spoke dispensing, and the impact of decommissioning on this type of dispensing model, which is becoming ever more popular with our group customers.
There is also a lack of clarity on robot dispensing, used by a number of multiples. How will robots communicate with the national verification database? It is highly unlikely the existing N3 infrastructure will have enough bandwidth for efficient connectivity to the national spine, along with the national verification database for decommissioning.
We urgently need consultation on what bandwidth is needed and how it will be funded. Community pharmacists are required to register their premises in just under 12 months to authenticate to the national verification system in readiness for FMD.
There are a number of outstanding issues around how this process would work if there were to be a change of ownership, and the impact on trading if there were delays in registration and therefore authentication to the NVS.
The FMD is an important element in the drive to ensure high standards of safety of medication in the UK. We are working hard on the technology to support our community pharmacy customers meet the deadline.
With a concerted effort from pharmacy bodies (and government) to address these outstanding queries, we should all get there. February 2019 may seem a long way away now but it will soon be upon us.