To all pharmacists who have already renewed their APC – thank you. We wish you all the best in your practice in the upcoming year.  

As we are heading towards the end of the 2022/23 recertification year, it is critical for those who haven’t renewed your APC, to do so before 31 March 2023. Your current APC expires next week on Friday, 31 March. You need your APC renewed in order for you to continue working from 1 April 2023 onward.  

APC renewal is a straightforward process and can be completed in less than 10 minutes via your Pharmacy Council online account. We understand that this year, completing the Continuing Professional Development (CPD) may have been difficult for the pharmacists practising in the cyclone-affected areas. If you have been severely impacted, please email [email protected] to discuss the alternative plan for your CPD requirements. 

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April 2024 is when new standards and guidance documents come into force and become mandatory. Our team is working on the final visual layout for the new standards. You will be notified when the documents are in place and available for you. 

The Health Practitioners Disciplinary Tribunal (HPDT) holds disciplinary proceedings against health practitioners — including pharmacists — who are alleged to have breached standards of practice. 

Read the recent Feras Dawood precis

This matter was investigated by the Health and Disability Commissioner (HDC) and subsequently referred to the Director of Proceedings (a decision maker who is independent of HDC) who decided to lay a charge with the Health Practitioners Disciplinary Tribunal (HPDT).

This article sets out the learnings pharmacists can take from two recent decisions of the Health and Disability Commissioner (HDC), where both the pharmacists and the pharmacies were found to have breached the Patient Code of Rights following dispensing errors.

Pharmacy fails to provide services of an appropriate standard  

This investigation centred around three dispensing errors made by a relatively junior pharmacist Ms B: incorrect strength; incorrect medication; and incorrect instructions given to the patient.  

Case description 

The investigation identified a further 22 dispensing errors had been made in the last 12 months, 16 by Ms B and six by the pharmacy manager. The pharmacy was in the middle of a supermarket.  

Ms B was working shifts of between six and 11 hours, five days a week as sole charge with one technician. HDC identified concerns about the systems in place at the pharmacy in particular, a lack of oversight and support, inadequate staff levels and lack of adequate monitoring to identify the high number of dispensing errors occurring to enable a timely response. 

HDC action 

HDC identified issues with the final checking process, including being distracted by customers during checking; failing to check medication accurately against the original prescription; and failing to change a warning label which did not match the prescription. The latter two issues were categorised as severe departures from accepted practice, as well as the pharmacy’s standard operating procedures (SOPs).  

The investigation highlights the importance of: 

1. the need for all pharmacists to be provided with learning opportunities including working alongside more experienced staff, 
2. maintaining adequate staffing levels, including providing cover for breaks, and further, fostering a culture where pharmacists can ask for support and issues can be escalated appropriately (this is particularly important for newly established teams or those with junior staff members); and finally,  
3. all pharmacists following basic principles of checking the medication and label instructions to reflect the original prescription.  

Adhering to professional standards and pharmacy standard operating procedures vital for the safe dispensing of medication  

This investigation related to one dispensing error which resulted in omeprazole prescribed for a baby being contaminated with methadone. The baby was hospitalised for 10 days. 

Case description 

The error occurred when pharmacist Mr A dispensed methadone into a bottle for a visiting patient prior to pharmacy computers being turned on. Mr A became distracted and left the unlabelled bottle containing the methadone on the dispensary bench on top of the prescription.  

Mr A said the computer system could not record the dose or print the label until the patient arrived. A technician then inadvertently used the bottle, assuming it was empty, for the baby’s omeprazole.  

Mr A checked the omeprazole in the measuring cylinder but did not perform a final check of the medicine in its mission bottle. When the error was identified, the pharmacy had difficulty obtaining contact details of the baby’s mother. 

A few hours later Mr A, called the baby’s mother and, as they were unable to get through, left a voicemail. The technician reached the baby’s mother later that afternoon, the mother handed the phone over to the paediatrician and Mr A participated in the conversation but did not take over the call from the technician. 

HDC action 

HDC found the failure to label and store the methadone appropriately was careless and unsafe. It was the first of several errors in effect. Mr A should have had procedures in place to ensure accurate and careful dispensing. Failure to undertake a final check of the omeprazole liquid in its mission bottle was also noted as a severe departure from accepted practice (the second error).  

Further (and third error), given the severity of the dispensing error and potentially life-threatening outcome, Mr A should have prioritised contact with the parent and the paediatrician. Delegating this task to a technician was inappropriate and did not comply with the pharmacy’s SOPs.

The investigation highlights the importance of: 

1. labelling immediately to prevent mislabelling of medication, 
2. completing the fundamental step of checking the medication against the prescription. Not only does this apply to controlled drugs but is standard practice and an important assurance to prevent dispensing errors, 
3. following SOPs which should take into consideration professional guidelines and legislative requirements. To mitigate workplace distractions and increased work pressures, SOPs should provide guidance to maintaining a logical, safe, and disciplined procedure, keeping clutter and distractions to a minimum, 
4. good communication between dispensary staff is crucial to avoid assumptions and confusion, 
5. consider increasing wait times to cope with staff shortages and to ensure safe dispensing. 

When a dispensing error occurs, pharmacists are expected to use professional judgement to determine the seriousness of dispensing errors, the urgency of follow up required, and whether delegation is appropriate.   

In light of recent complaints made to Council regarding pharmacists’ online presence, we remind pharmacists the Code of Ethics requires pharmacists to demonstrate accepted standards of professional and personal behaviour in any form of communication, including social media.  Additionally, the Health Information Privacy Code 2020 requires pharmacists to only use patient information for the purpose it was obtained. 

We have recently made a submission on the Therapeutic Products Bill (the Bill). The submission describes Council’s view on the interface between the Bill and the Council’s regulatory work and the need for the two-regulatory models to work effectively alongside each other.

The Bill sets out the future legal framework for ensuring that therapeutic products in Aotearoa New Zealand are safe, effective, and of high quality. The Bill also proposes creation of the Therapeutic Products Regulator (TPR).

We are concerned that there is (and will be) two regulators in this space (Pharmacy Council and the TPR) and that the Bill needs to properly recognise this for effective regulation. This is a once-in-a generation opportunity to get this right. 

Our submission focused on the crossover between the Bill and Council’s regulation of pharmacists, and how this would ensure safe community pharmacy services.  

We submitted that if a two-regulator model is to continue, it should be mandated that both regulators work closely to develop regulation, rules and information sharing arrangements.

Good regulatory intelligence through information sharing is a must to allow Council to carry out its responsibilities for the competence and conduct of pharmacists, especially those named as responsible persons on a pharmacy licence. 

We encourage you to read our submission see here. 

Michael and Christine (Registrar) attended the White Coat Ceremony at the University of Otago that took place at the end of February. It was an amazing opportunity for us to meet the new cohort of young people joining the pharmacy profession.   

It is a significant milestone for students entering their career and we appreciate being part of this milestone. We gave a short speech on Council’s role and together read the Pharmacists Code of Ethics with the students. 

We focused our speech on sharing awareness around our supportive approach to the HPCA regulation. We trust practitioners within the profession to do the right thing, and if we are put in a position where we have to question it, we have mechanisms in place to get practitioners back on track. 

We appreciate students’ dedication, knowledge, and passion. You have joined a respectable and trustworthy profession that will provide you a rewarding career.

On Friday, 10 March 2023, Michael and Natalia (our Senior Advisor Māori & Health Equity), along with the symposium participants and keynote speakers, were warmly welcomed to Ōwhata Marae in Rotorua. Ōwhata marae is significant to Ngā Kaitiaki o Te Puna Rongoā o Aotearoa as it is where the first Māori pharmacist was from, Matua Hiwinui Heke.  

Matua Hiwinui has provided the organisation with a haven to call their own, their turangawaewae (place of belonging). It was our honour as guests to stand amongst the organisation and feel the wairua (spiritual feeling) that filled the air. 

Matua Hiwinui also gifted our name, Te Pou Whakamana Kaimatū o Aotearoa. 

Ngā Kaitiaki o Te Puna Rongoā o Aotearoa the Māori Pharmacists’ Association of New Zealand (MPA) is an organisation driven by its vision to lead the pharmacy sector to be responsive to the needs of Māori.

It was instrumental in ensuring the relevant New Zealand competency standards for pharmacists relating to Hauora Māori (Māori Health) were implemented. MPA’s whakatauāki guides it (Ka piki te wai, ka heke te ua, ka puta te puna, hei rongoā).

Traditionally Māori hapū and iwi will congregate around a healthy source of water and be sustained in good health by that puna and likewise will care for that puna in return.

The metaphor is made current in light of how a pharmacy, or pharmacist is rightly seen as a central hub, a central source of health information, and thereby provides the people with those things that help to maintain their health.

Future Focus – Be the Change 

The connectedness to Ōwhata marae ensured the objectives of the symposium were alive. Identifying strategies for engaging and building relationships with Māori, opportunities for whakawhanaungatanga (connections/networking) and how one might strengthen their own understanding of te ao Māori and what that means for us all as clinicians. 

The day was led by MPA President, Mariana Hudson (Te Whakatohea) who connected the kaupapa of the day to the well-known love story of the marae tupuna, Tūtānekai and Hinemoa, and how the call has been heard by our sector to contribute positively to the transformation of the system.  

It was then supported by Riana Manuel (Ngāti Pukenga, Ngāti Maru, Ngāti Kahungunu) who set the navigational direction of Te Aka Whai Ora and where our sector fits into it. From here we heard inspiring kōrero from our keynote speakers and tauira (students). 

The Māori tauira coming through both University of Auckland and University of Otago Schools of Pharmacy are empowering. These students represent the future of pharmacy and have MPA as mentors and role models. These tauira presented their research findings to date on: 

• distributing an educational video regarding the experiences Māori patients have with, and expectations Māori patients have of, pharmacy services in Aotearoa,
• the Ongoing Effects of COVID-19 Vaccinations,
• investigating how community pharmacists in Aotearoa would feel about supplying Gina to relieve genitourinary symptoms of menopause,
• exploring the lived experiences of Māori whānau during eye examinations in Neonatal Intensive Care Unit, to determine the degree of retinopathy due to prematurity,
• exploring training needs, benefits, and challenges of developing community pharmacists as researchers to find ways to encourage more community pharmacists as researchers.

There were presentations that took the voice of Māori whānau, Mātauranga Māori, to reflect on the work happening within the health sector and reforms, and discussed ways that the pharmacy sector and pharmacists can action change to improve outcomes for, and with, Māori whānau and communities. 

The mana of the keynote and panel speakers was evident in how the wharenui responded. Their leadership, hard work, whānau, their mana wahine and mana tāne silenced, engaged and intrigued the audience. 

The fifth and final tranche of the Pharmacy Team Relief Fund has closed. The Fund was offered in October 2020 by the Ministry of Health and administered by the Pharmacy Council to provide relief to community pharmacists and technicians who were affected by the front-line pressures of the Covid-19 pandemic.

Through this initiative we were able to provide support to over 300 pharmacies throughout New Zealand. The Fund provided community pharmacies with the equivalent of 575 full-time pharmacist weeks, 323 full-time technician weeks, and the necessary travel and accommodation costs to get locum support to where it was needed. 

The Fund was an important step in ensuring that community pharmacies were able to continue providing essential healthcare services to the public during the pandemic. We wish to express our gratitude to the Ministry of Health for providing this support for the pharmacy sector.

The Education Forum was held on 1 February. Council engaged with the education providers to determine what possible factors may have contributed to the poor Assessment Centre results last year.

It was agreed that it is multi-factorial and there is no easy fix. Council and the providers are beginning a programme of engagement with affected parties to further explore and understand possible contributing factors and what may need possible enhancements. 

If you are a practising pharmacist interested in being a part of Pharmacy Council work, there is an opportunity for you to join with us! Go to the vacancies page to read more about available roles.