Pharmacy inpatient services
The role of the Pharmacy Department at University Hospitals of North Midlands is to support the safe and effective use of medicines for all our patients. Our vision is centred on:
"Delivering excellence and innovation in medicines optimisation and pharmaceutical care for the benefit of our patients, customers and staff."
The Pharmacy department employs over 220 people including Pharmacists, Pharmacy Technicians, Pharmacy Assistant Technical Officers and Clerical staff, all of whom play a vital role in providing medication and advice to our patients.
We issue over 700,000 items a year, at a value in excess of £30 million from the department.
The dispensary has a state of the art robotic dispensing system at the heart of the operation. In addition, we have a licensed aseptic manufacturing unit which produces highly specialised medicines including cytotoxic (chemotherapy) infusions and parenteral nutrition feeds.
Our dedicated team of Pharmacists and Medicines Management Technicians provide advice to medical and nursing staff across the hospital.
The Directorate has 5 core services:
- Patient Services and Distribution (Dispensary and Stores)
- Technical Services
- Governance, Medicines Safety and Medicines Information
- Clinical Information and Procurement
- Clinical Services
Outpatients
If you are coming to an out-patient appointment, please bring an up to date list of your medicines with you; this should be available from your GP. Also if you have an exemption to prescription charges, including pre-payment certificate, bring evidence of this with you in case you have to get a prescription dispensed.
Outpatient dispensing is done at the LloydsPharmacy based in the Atrium of the main building.
Queries about your medicines…..?
If you have recently been an inpatient and have any concerns or questions about the medications given to you, please contact our Medicines Helpline on 01782 674537 which is open Monday to Friday 10am to 1pm and 2pm to 4pm. Please have all your medications and a copy of your discharge letter available.
There is also a product specific patient information leaflet provided with every medicine you are supplied with which may answer your questions.
If you have a query and it is more than 14 days since you were discharged from hospital, please refer to your local community pharmacist or your GP.
- Aseptic and chemotherapy production
- Non sterile manufacturing
- Pre-packing and quality control services (including medical gas testing)
- A chemotherapy dispensing satellite unit operates from the UHNM Cancer Centre
- A dedicated clinical trials team (oncology and non-oncology)
In the Aseptic Manufacturing Unit we prepare intravenous nutrition products for adult, paediatric and neonatal patients. These are complex products tailored to the nutritional needs of our individual patients. In the aseptic unit we also prepare antibiotic injections for cystic fibrosis patients. This allows these patients to be treated at home avoiding unnecessary hospital stays.
In the chemotherapy manufacturing unit we prepare a range of chemotherapy agents for our cancer patients. We also prepare chemotherapy for a number of leading cancer clinical trials, ensuring our patients have access to, innovative therapies.
In the non-sterile manufacturing unit we prepare bespoke creams and ointments when commercially available preparations are not suitable. We also prepare a range of medicines in liquid form which are often required for either paediatric patients or adult patients who cannot swallow medication in either tablet or capsule forms.
In the pre-pack unit we label commercially available medicines with instructions to patients how to take their medicine. These packs are then supplied to A&E, outpatient clinics and ward areas to be given to patients immediately at the point of discharge. These are especially useful out of hours, enabling patients to be discharged more effectively.
There is a satellite dispensing unit based in the cancer centre and there is a team of Pharmacists and Technicians dedicated to the provision of medicine including chemotherapy to the ward and day case unit in the Cancer Centre.
Specials
The Pharmacy Manufacturing Unit holds an MHRA Manufacturer's "Specials" Licence.
'Specials' are unlicensed medicines created for patients for whom there are no existing suitable licensed products available, for reasons of formulation and/or presentation.
Reasons for unsuitability may include:
- Allergies to conventional ingredients
- A unique combination of ingredients
- Unacceptable presentations e.g. flavours, dysphagia, needle-phobia
This service provides Trust-wide leadership on governance arrangements and safety initiatives involving medicines (e.g. safety alerts relating to medicines, controlled drugs and medicines optimisation) and the team also delivers medicines-related training to Doctors, Nurses and other allied health professionals.
The Medicines Information team provides a service to support the safe, effective and efficient use of medicines by the provision of evidence-based information and advice on their therapeutic use.
The team provides a service to healthcare professionals across the Trust. Enquiries are also taken from healthcare professionals in primary care and members of the public. The Medicines Information team provides a first line enquiry answering and advisory service on all aspects of drug use including:
- drug interactions
- adverse drug reactions
- dosing and frequency of medicines
- safety of drugs
Medicines Helpline
If you have recently been an inpatient at the hospital (i.e. within the last two weeks) and have a query with your medicines, please contact the Medicines Information Team on 01782 674537 (helpline open Monday to Friday 10am to 1pm and 2pm to 4pm). Please have all your medications and a copy of your discharge letter available.
If you were discharged from hospital more than two weeks ago, please contact your GP or local community Pharmacy.
The Patient Services and Distribution section of Pharmacy has an integrated dispensary and store with automated dispensing, supplying medicines and pharmacy related stock to wards, departments and wholesaling to external customers.
Inpatient dispensing
We process over 700 discharge prescriptions each week with around 4000 items being dispensed for them. Our aim is to dispense these prescriptions in as timely a manner as possible without compromising on patient safety. We also dispense all the medication for the patients in the hospital.
At the heart of the dispensary we have a state of the art robotic dispensing system. The robot acts as a giant vending machine: the pharmacy ward staff order the drugs electronically, the robot selects them automatically and they are then checked against the prescription by a member of staff before being taken to the wards.
The Pharmacy Distribution Service (Stores) provides a service to wards and departments throughout the University Hospital of North Midlands, and also holds a Wholesaler Dealer's Licence which enables the Pharmacy to supply medicines to other legal entities such as other healthcare trusts in Staffordshire and throughout the UK and local community pharmacies.
The department purchases on average, drugs to the value of £30m and provides over 700,000 items to patients every year. The store holds approximately 2,500 active stock lines and on average we process 30,000 issues per month.
The clinical services section of the Pharmacy Directorate provides a ward and dispensary-based clinical pharmacy and medicines-management service. The service is delivered by registered Pharmacists and Pharmacy Technicians who will:
- Check your medication history and ask you if you have any allergies
- Talk to you about all of your medicines
- Give you access to written information about your medicines. (This will normally take the form of a product patient information leaflet which is supplied with every product)
- Give you the opportunity to ask questions about your medicines, for example any potential side effects.
During your stay in hospital, the Pharmacy team will ensure that you have a sufficient supply of medication for your hospital stay and at least two weeks supply to take home.
The Pharmacy team works to ensure that:
- Your prescribed medication is as safe and effective as possible.
- Any medicines that you were taking before you came into hospital which are to continue are prescribed
- All medicines are prescribed correctly and safely on your hospital prescription chart
- All of your medicines are kept securely in your bedside medicines locker
The team of Pharmacists, Pharmacy Technicians and clerical staff are responsible for:
- the procurement of medicines
- the provision of financial information on medicines usage / expenditure
- the joint primary/secondary care formulary
- antimicrobial support.
Procurement
Medicines are an essential component of health services and are the most common clinical intervention provided within the NHS. They cost the NHS around £12billion a year. This means that, second to staff costs, medicines are the biggest single budget expenditure in the NHS.
The Pharmacy Procurement Team purchase medicines in as cost effective a manner as possible, consistent with patient needs and in accordance with all the relevant professional and audit standards. They also provide the various clinical specialties within the Trust with information about the usage and expenditure of drugs within their areas.
North Staffs Joint Formulary
The North Staffs Joint Formulary is the approved medicine formulary for use within Primary and secondary care within North Staffordshire.
A formulary is a list of medications that are readily available in the hospital pharmacy. The aim of the formulary is to encourage safe, rational and cost-effective prescribing, and to have a unified choice of treatment for patients in the North Staffordshire area to ensure seamless transition of care for patients between the UHNM and general practice.
Antimicrobial Support
Antimicrobials, when used correctly, can be live-saving. However they can sometimes be used inappropriately and this misuse can introduce risks into patient care, such as adverse reactions, increased risk of antimicrobial resistance and increased risk of Healthcare Associated Infections (HCAI).
The team provide support and information to all hospital staff in the UHNM who are involved in the prescribing and use of antimicrobials in order to maximise safe, effective care and minimise any associated risks to individual patients and public health.
Meet the team
Kate Milner – Production Manager – Chief Pharmacy Technician
The team of which I am a member is responsible for the provision of services from the MHRA licensed Technical Services Department. This includes non-sterile manufacturing and assembly of liquids and topical preparations, the re-packaging and over-labelling of tablets, capsules, semi-solid formulations, injections, inhalation devices and liquids and the assembly of emergency boxes and trauma kits.
It also invovles the compounding of parenteral nutrition solutions, preparation of syringes, infusions and ambulatory devices of aseptic and chemotherapy agents to meet both batch and patient specific requests and preparation of pharmaceuticals in the radiopharmacy department.
We are also responsible for the quality management system required to provide these services.
The responsibility of the production manager includes staff management and deployment, organisation and oversight of these services and ensuring compliance with the terms of the MHRA license. The continued maintenance of this license is an achievement both for the department, the trust and our patients.
Laura Morris - Patient Services - Dispensary Lead
As dispensary lead I work closely with the senior pharmacy technician for patient services to ensure the smooth day-to-day running of the dispensary.
I consider the dispensary as the heart of pharmacy and a pivotal element of the hospital pharmacy network. We support ward-based services through the provision of stock and medication for in-patient use and we support patient flow by processing discharge prescriptions. In addition, we provide vital counselling and advice to patients attending from busy outpatient clinics. These are just a few of the functions the dispensary provides.
A key part of my role is to facilitate the flow of work through the department in an efficient and safe manner to ensure patients have the best possible experience on their hospital journey and to ensure wards and clinics have the medicines they need, when they need them.
The diversity of work coming through the dispensary means it's never dull. There are always new drugs and regimes evolving which enable us to continually learn, grow and develop in the ever-changing world of pharmacy.
I also have the opportunity to educate and mentor pre-registration pharmacy technicians through my extended role as NVQ assessor. Sharing my experience and seeing others thrive in pharmacy is a particularly rewarding part of my role and I am proud to be part of UHNM.
Lisa Lloyd - Senior Medicine Information Safety Pharmacy Technician
I am excited to have recently started in a new advanced role for pharmacy technicians where I will be managing medicines information.
This will include researching and responding to medicine information queries, managing resources and updating policies and procedures, ensuring all information is up to date and accurate. It will also invovle leading audits, producing reports and providing training.
In my previous role as Medicines Management Pharmacy Technician, my proudest achievements were winning the divisional 'Employee of the Month' award, being awarded an 'Improving' badge for putting systems in place on my ward to improve medicines practice and implementing 'Drug of the week' to support staff development.
I am very enthusiastic about learning new skills and developing myself and my colleagues to ensure patient safety takes precedence.
Loraine Edwards – Chief Technician for Clinical Information
I am very proud to be Chief Technician for the clinical information team. Our role includes providing information to the finance team to facilitate the recharge of medicines that are not in-tariff and medicines funded by the cancer drugs fund, as well as provision of medicines expenditure information in clear concise reports. We also maintain the pharmacy computer system to ensure we have a safe system to order and invoice medicines and label medicines safely and efficiently for our patients.
We support the specialist pharmacist team with quantifying cost savings resulting from medicines optimisation schemes and provide data for national benchmarking. We also help with monitoring adherence to local formulary and antimicrobial guidelines, manage the outsourced outpatients department account, and maintain the Trust's entries onto the national immunoglobulin database.
Our band 5 technicians support the Trust's sub-regional immunoglobulin assessment panel and they co-ordinate requests and responses from other Trusts.
We also respond to medicines-related 'freedom of information' requests.
Recently Dawn Howell, one of our band 5 technicians, was promoted to a band 6 role supporting the roll-out of electronic prescribing and medicines administration.
Sian Rooney – Deputy Medication Safety Officer/ Chief Pharmacy Technician for Medicines Safety
The medicines safety team ensure safe medicines management through a robust governance framework.
My role includes making processes safer through policies, training and sharing good practice, as well as learning lessons from incidents, audits and national safety guidance. I also provide direct support, for example root cause analysis and controlled drugs management.
My proudest achievements as are improving the organisational management of controlled drugs adverse incidents by regular review, recommendations and setting up a new controlled drugs root cause analysis panel, as well as winning 'Team of the Year' for our medicines waste project and introducing pharmacy technician autonomous ordering of medicines.
I am passionate about patient safety and take pride in communicating and engaging with others to motivate and inspire action.
Patient services
Our aim is to deliver excellence and innovation in medicines optimisation and pharmaceutical care for the benefit of our patients, customers and staff.
The pharmacy patient services team at UHNM delivers a crucial service at both Royal Stoke and County Hospital and comprises three key areas:
Dispensary Services – Here we process the majority of the prescriptions for in-patients, discharges and outpatients. Our technician team will dispense complex prescriptions, manage the department and perform the final accuracy check.
Ward Services - Our team of skilled technicians and ATOs support at ward level with the pharmacists, nurses and medics.
Training and development – By supporting our team with the best training and development opportunities we have a more skilled and empowered team.
There are many varied roles within these teams which allow staff to develop and progress within the scope of the technician role.
Procurement
The UHNM pharmacy procurement team is predominantly a technician-led service with one chief pharmacy technician supported by pharmacy technicians and assistant technical officers. Pharmacy technicians work closely with pharmacists and clinicians to ensure timely and consistent supply of medications.
The key responsibilities of pharmacy Ttchnicians include managing supply shortages by identifying and sourcing alternative medicines, contingency planning to ensure continuity of supply throughout Brexit and supporting Department of Health contracting to ensure we obtain the most cost-effective medicines.
It also involves participation with regional projects to develop good practice across the country, sourcing critical and rarely used medicines and providing homecare medicines services to over 1000 patients.
Pharmacy procurement technicians have had an increasingly central role in the oversight of regional and national procurement. UHNM staff have previously chaired regional procurement groups and will be involved in the West Midlands Brexit strategy workforce.
Stores and distribution
UHNM pharmacy stores is managed by a senior pharmacy technician with support from assistant technical officers. The trust holds a wholesalers licence which enables Pharmacy to supply to external customers.
Some of the key areas that technicians are responsible for within this area are regular self-audit of services to ensure UHNM complies with regulators, management of stock in order to ensure medication availability and reduce wastage and monitoring and assurance of storage conditions to ensure medications are safe for patients.
They also help to safeguard against falsified medicines entering the department and being issued within the Trust and link in with the procurement team to ensure contract changes are implemented for issue. This ensures wards have access to the right medicines at the right time to treat patients.
Ward Services
Our highly motivated technician team are a crucial piece of the UHNM jigsaw who support the ward pharmacists and prescribers to ensure that our patients get an excellent pharmacy service. Our duties include identifying priority patients for clinical review, doing medicines reconciliation, enhanced patient counselling and managing the flow of discharge prescriptions from the wards through our ward-based pharmacy hubs or dispensary.
Within this team we also have some enhanced roles where staff are taking on more clinical aspects.
Emma is one of the Medicines Management team with eight years' hospital experience. She has recently been involved in a new innovative project to improve the safety of diabetic patients awaiting surgery and she works closely with the senior surgical pharmacist to identify at-risk patients.
By contacting those patients a week prior to surgery Emma can make sure that their medication is correct and up to date prior to admission and also get their prescription chart ready so no doses of critical medicines are missed on admission.
This is just one of our exciting projects and we are continuing to enhance the skills of our ward-based technicians and motivate others.