Clinical governance is the system through which pharmacists are accountable for continuously improvement and safeguarding high standards of care.

What does good clinical governance in pharmacies look like and why is it important?

With pharmacies increasingly providing a broader range of clinical services, the need for good clinical governance has never been more important.  This is particularly important for online pharmacy settings where the risks are, perhaps, the greatest.

The starting point for pharmacies should always be the General Pharmaceutical Council’s standards and guidance for registered pharmacies.  The standards are grouped under five principles:

• the governance arrangements safeguard the health, safety and wellbeing of patients and the public,
• staff are empowered and competent to safeguard the health, safety and wellbeing of patients and the public,
• the environment and condition of the premises from which pharmacy services are provided, and any associated premises, safeguard the health, safety and wellbeing of patients and the public,
• the way in which pharmacy services, including the management of medicines and medical devices, are delivered safeguards the health, safety and wellbeing of patients and the public,
• the equipment and facilities used in the provision of pharmacy services safeguard the health, safety and wellbeing of patients and the public.

GPhC data and research have identified common threads which are “key to driving good clinical governance”:

• an ethos of continuous learning and improvement
• placing governance, risk assessment, clinical audit, training and development, and oversight of prescribing and clinical services on an equal footing to dispensing services
• adopting automation and digital technologies
• engaging with patients using a wide variety of consultation modes
• creation of integrated roles, induction handbooks, structured staff training, standard operating procedures, performance development plans, appropriate team skill-mix, and protected learning time optimised workforce recruitment, retention, and good clinical governance
• Medication safety was a key governance focus.

Drawing conclusions from this, the data and research concluded that:

1. clinical governance arrangements should be defined to include clear definitions of the roles and accountabilities of the people involved in providing and managing pharmacy services.
2. with the advancement of prescribing and service delivery in pharmacies, pharmacy professionals’ clinical skills, scopes of practice, education, training, and development would be expected to align with the expansion of those services.
3. As services evolve across GB, it is essential that pharmacy teams have the appropriate skills, knowledge and experience for their role and the tasks they are asked to undertake.
4. Interoperability and standardisation of record keeping and clinical documentation across all settings will aid consistency of consultations, communication with the wider healthcare team, and optimal use of digital information.

Regular Audits

Undertaking regular audits of clinical governance and associated arrangements in pharmacies will provide pharmacists and their staff with valuable insight and drive improvement.  Undertaking regular audits that drives improvement will also be invaluable evidence during an inspections undertaken by the GPhC, either proactively or reactively in response to complaints.

Are you qualified to undertake meaningful audits of your own clinical governance and associated arrangements?  Do you understand the fitness to practise implications when a pharmacy is the subject of enforcement action?