New proposals which suggest pharmacists should be protected from prosecution when making ‘inadvertent dispensing errors’ are said to have been drawn up to create a culture of ‘openness’ in which ‘everyone can learn from their mistakes’.
Indeed, the Department of Health says the proposals will bring the treatment of pharmacists and pharmacy technicians in line with the handling of errors made by other healthcare professionals, such as doctors and nurses.
“Removing the threat of criminal sanction for inadvertent preparation and dispensing errors will address a significant fear amongst pharmacy professionals, which is currently inhibiting the reporting of such errors,” the Rebalancing Medicines Legislation and Pharmacy Regulation proposals claim.
“Ultimately, this change should support increased reporting and learning from errors, thereby improving patient safety and promoting better professional practice,” it concludes.
All sounds very good to now.
However, when reviewing the proposals in full detail, there appears to be a number of contradictions which I fear will not lead to greater openness and transparency throughout the pharmaceutical profession, but could actually lead to more secrecy and denial.
In effect, the proposals may only succeed in protecting pharmacists from not only criminal proceedings, but civil action too.
I say this because, worryingly, the proposals suggest some patients may not be informed of an error in dispensation at all if considered to be ‘trivial’ by those making the error.
It is also recommended that any suspicions of errors within a pharmacy should not be communicated to patients until an investigation has confirmed the dispensing mistake has in fact been made.
Now, whilst officials claim these new proposals will bring pharmacists in line with other health professionals in offering them protection from criminal action, the suggestion of not informing patients of some errors at all does not sit well at all.
The Duty of Candour, introduced last November, sent a very clear message throughout the NHS that there would be no excuses for covering up errors of any scale.
That guidance could not have been more different to what is now being suggested for pharmacists, in that it said Health Trusts must always be open and honest with patients or their families when things go wrong.
The fear has to be that more errors will be covered up if these proposals are approved.
People will take decisions that patients ‘need not know’ of their mistakes, and in that kind of environment, lessons can never be learned and standards will not be improved. It will simply allow mistakes to be brushed under the carpet.
These proposals, in my view, will not protect patients or improve the standards of pharmacists.
They will simply protect pharmacists from any kind of external scrutiny and accountability, and that would be a dangerous route to take.