About The Book

 The practice of pharmacy in secondary and tertiary care has changed dramatically over recent years, corresponding to considerable changes in modern healthcare provision. The pharmacy department is now an established part of most hospitals — the pharmacy team playing a pivotal role in patient care. Hospital Pharmacy outlines the changes in pharmacy practice within the hospital setting and discusses the vast range of services that are now provided. Each chapter is devoted to an area of pharmacy practice and discusses its history, current practice and future developments. As well as considering well-established facets of hospital pharmacy practice, such as technical services and clinical pharmacy, this text also covers the evolving relationship of the hospital pharmacy with other healthcare departments. This book is essential reading for pharmacy undergraduates, preregistration graduates and newly qualified pharmacists. With its broad, all-encompassing coverage it will also be of interest to other healthcare professionals.





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Table of Contents

Preface xi
About the editor xiii
Contributors xv
Abbreviations xvii
Introduction xix
Hospital pharmacy xix
Documents key in hospital pharmacy’s development xxi
Conclusion xxii
References xxiii
Further reading xxiii
1 Hospital pharmacy within the National Health Service 1
History 1
The new NHS until 2002 3
Evolution of primary care organisations 5
Scotland 6
Wales 6
Northern Ireland 6
Shifting the Balance of Power 7
The NHS Plan 7
NHS hospital trusts 8
Pharmacy’s place in a trust 10
Pharmacy staff 13
The future 14
References 15
Further reading 15
2 Purchasing medicines 17
Background 17
History 18
Hospital procurement and the application of EU legislation 20
The strengths of the contracting process 22
The organisation of hospital contracts 22
Systems and processes 24
Recent changes 25
Local arrangements 25
The future 27
References 27
Further reading 28
3 Medicines supply 29
History 30
Current practice 31
The future 42
References 44
Further reading 45
4 Technical services 47
History 48
Repackaging (prepacking, assembly) 51
Non-sterile manufacture 54
Sterile manufacture 57
Aseptic preparation 60
Education and training for hospital technical services 67
Health and safety and environmental issues 68
The future 68
Acknowledgement 70
References 70
Further reading 71
5 Quality assurance 73
The NHS quality agenda and the role of the QA pharmacist 74
The aims of NHS pharmaceutical quality assurance services 76
Development, issue, implementation and monitoring of standards and guidance 78
Quality assurance and quality control of medicines 78
Quality assurance of pharmacy services 79
Quality assurance of aseptic services 80
Quality audit 81
Advisory services 81
Research and development 82
Testing piped medical gas installations 82
Training of pharmacy staff 82
Defective medicines 83
Laboratory services 83
Environmental monitoring services 86
The future 87
References 88
Further reading 90
6 Medicines information 91
History 91
Structure and activities 92
Aims and strategy 93
Roles and skills 95
Ethics and legal issues 95
Clinical governance and risk management 99
Customers/users 104
Activities 105
Specialist information services 113
Information resources 114
Information technology 115
Staffing and training 116
The future 118
Conclusion 118
References 119
Further reading 120
7 Clinical pharmacy services 121
Definition of medicines management 121
Ward pharmacy 121
History 122
Clinical pharmacy 124
Pharmaceutical care 125
Activities that are components of the delivery of pharmaceutical care in hospitals 126
Services linked to clinical specialities 136
Moving into prescribing 143
The future 145
References 146
Further reading 150
8 Strategic medicines management 151
Clinical risk 151
Financial risk 151
History 152
Strategic medicines management in practice 154
External influences on strategic medicines management in hospitals 165
Conclusion 167
References 168
Further reading 169
9 Managing risk 171
Controls assurance 171
Quality in the NHS 174
Risk management 178
Conclusion 184
References 184
Further reading 186
10 Community services pharmacy 187
History 187
What are community health services? 190
Advice 190
Supply 192
Information 195
Education and training 195
Monitoring safe practices with medicines 196
Supporting the implementation of public health programmes 196
School nursing and school vaccination programmes 196
Residential and nursing home – inspection and training 197
Supporting intermediate and continuing care services for the elderly 198
Support for people with learning disabilities 199
Working with other agencies 199
The future 200
References 201
Further reading 202
11 Information technology 203
History 203
Electronic data interchange 204
Stock control systems 205
Electronic patient record 206
Automation 208
Conclusion 209
References 209
Further reading 210
12 Research and development 211
Definitions 211
History 212
Project design 214
The future 220
References 221
Further reading 222
13 Education and training 223
History 223
The present day 225
Management and leadership 229
The future 229
References 230
Further reading 231
14 Managing services 233
Pharmacy management 233
Business planning 236
Preparing a business case 237
Budget management 238
Benchmarking 240
Staff management 243
Conclusion 251
References 251
Further reading 251
15 Support organisations 253
Hospital Pharmacists Group (HPG) 253
British Pharmaceutical Students Association (BPSA) 254
The College of Pharmacy Practice (CPP) 254
United Kingdom Clinical Pharmacy Association (UKCPA) 258
European Society of Clinical Pharmacy (ESCP) 259
Centres for Pharmacy Postgraduate Education 261
Guild of Healthcare Pharmacists (GHP) 264
References 265
Further reading 265
Index 267





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