Pharmacy (Preparation and Dispensing Errors—Hospital and Other Pharmacy Services) Order 2022

Baroness Walmsley Excerpts

Monday 23rd May 2022 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, the Pharmacy (Preparation and Dispensing Errors—Hospitals and Other Pharmacy Services) Order 2022 was laid before Parliament on 28 April. This draft order extends to the United Kingdom. I note that the noble Lord, Lord Hunt, has submitted a Motion to Regret in relation to the draft Pharmacy (Responsible Pharmacists, Superintendent Pharmacists etc.) Order 2022. This will now be subject to a separate debate.

The draft order before your Lordships has been in development for a long time under the auspices of the Rebalancing Medicines Legislation and Pharmacy Regulation Programme Board, whose members include representatives from across the pharmacy sector and professional and regulatory bodies. The draft order is welcomed by pharmacy professionals working in hospitals and relevant pharmacy services, and has the support of the four Chief Pharmaceutical Officers of the UK.

I apologise for the parliamentary time taken to progress this order. The Government had to make some difficult decisions to deprioritise non-urgent legislation following the general election in 2019, EU exit and the Covid-19 pandemic. We are now returning to more business-as-usual matters.

The purpose of the order is to extend the defences already available to pharmacy workers in community pharmacy premises made under the Pharmacy (Preparation and Dispensing Errors—Registered Pharmacies) Order 2018 to ensure that registered pharmacy professionals working in hospitals and other settings, such as prisons and care homes, have access to the same defences. This would provide them with access to the defences to the criminal offences set out in Sections 63 and 64 of the Medicines Act 1968, which concern the adulteration of medicinal products in Section 63 and the sale of any medicinal product which is not of the nature or quality demanded by the purchaser in Section 64. The order makes these defences available in defined circumstances and, importantly, incentivises the reporting of errors where pharmacy professionals make genuine dispensing errors, improving learning to prevent such errors occurring.

In summary, the order will support improved patient safety by encouraging a culture of candid and fulsome contributions from those involved when things go wrong. This is a culture we want to see right across the NHS. Within this culture, pharmacy professionals can increase their learning from dispensing errors and identify mitigating action to make recurrence less likely in the future. I therefore commend the draft order to the Committee.

[Baroness Walmsley (LD)]

My Lords, I have always thought that the purpose of highlighting errors in the health service should be to learn and to avoid repeats, rather than to lay blame. That is why I supported the HSSIB, which was made mandatory in the recent Health and Care Act 2022. For that reason, I also support this order, which can contribute to patient safety by extending the removal of the threat of criminal sanctions for inadvertent dispensing errors beyond current community pharmacies and into other places where medicines are legitimately dispensed. These will include hospitals, care homes, prisons and detention centres. Anything which deters people shining a light on errors is a bad thing and should be addressed; anything which enables learning from them is welcome. However, although the order is welcome, I ask the Minister whether there has been evidence that staff have been deterred from exposing or informing patients about a mistake that has been made.

It is vital that the duty of candour that applies to all health professionals is upheld. I welcome the news from the General Pharmaceutical Council that it plans to develop new learning resources to help pharmacists understand how to fulfil this duty and, crucially, why they should do so. Of course, the duty already appears in the Standards for Pharmacy Professionals. This is where actual offences come into the picture. It is right that pharmacists could still be prosecuted if they can be shown to have had deliberate disregard for patient safety, as such a person would not be acting in the course of his profession, so patient protection still applies.

Identifying such a situation would probably rely on whistleblowers, who need protection and confidence that they would not be penalised for revealing information. Will the Minister say who would be responsible for making this judgment? Would it be the General Pharmaceutical Council or a magistrate with professional advice?