Introduction

Gloucestershire Hospitals NHS Foundation Trust Pharmacy provides a pharmacy service from Cheltenham General, Gloucestershire Royal, Cirencester and Stroud Hospitals through on site pharmacy departments. Pharmacy services are also provided from these bases to the Partnership Trust and PCT Community Hospitals.

Director of Pharmacy contact details:

Dr Peter Shaw. Tel: 08454 22 3025(CGH) or 08454 22 5512(GRH) or E-mail peter.shaw@glos.nhs.uk

Information for patients

Almost every patient who attends hospital for treatment will receive some form of medication. The pharmacy department is responsible for ensuring the availability of medication and is recognised as being the key source of expertise on medicines within the Trust. We aim to ensure that all patients receive the right medicines, for the right reasons, at the right time.

For patients coming into hospital who usually take medicines at home, we ask that all medication is brought into hospital with them. These medicines will be used (if appropriate) for the patients during their hospital stay. Other medicines may be prescribed whilst in hospital and the pharmacy can provide information on how they should be taken, their side effects and can answer any questions that a patient may have.

Information about the departments and roles

Cheltenham General Hospital and Gloucester Royal Hospital both have medicines information departments (see detailed information about medicines information) and sterile manufacturing units with specialist facilities for making up medicines (see detailed information about manufacturing units) and monitoring and controlling their quality. They also both have a stores and distribution service that are responsible for purchasing and distributing medicines to all the wards and departments in the hospitals.(see detailed information about stores)

In total the departments employ 183 staff including pharmacists, technicians, ATOs (assistant technical officers) and clerical staff.

PHARMACISTS

Pharmacists must be registered to work in the NHS. For this, they need a degree in Pharmacy from one of the Schools of Pharmacy approved by the Royal Pharmaceutical Society of Great Britain (RPSGB) then undertake a one year pre registration period within a pharmacy, followed by a RPSGB Registration exam. All qualifying pharmacy courses are at Masters Degree level and are four years in length.

PHARMACY TECHNICIANS

To register as a pharmacy technician you need an NVQ level 3 in pharmacy services or equivalent. The training involves both practical experience and study at a college or by open learning. It usually takes 2 years to complete.
Pharmacy Technicians with appropriate qualifications can register with the Royal Pharmaceutical Society of Great Britain. Currently, registration is voluntary. In the long term registration will be mandatory and only pharmacy technicians with acceptable qualifications will be able to join.

In hospital, there are several grades for pharmacists and qualified pharmacy technicians. Both can specialise in areas such as medicines management, manufacturing, quality control, staff training, information technology, supplies procurement, clinical trials and medicines information services.


ASSITANT TECHNICAL OFFICER (ATO)

To work as an ATO you will usually need to have a good standard of education.
Applicants would also usually need:

• Good communication skills
• The ability to read and carry out instructions
• Attention to detail
• Manual dexterity

ATOs work alongside pharmacy technicians and under the supervision of a registered pharmacist and senior technicians. Staff falling into this category will have a range of roles and responsibilities.

Dispensary

Each dispensary works following similar operating procedures and guidelines. The teams provide medicines for many areas both on and off site. We provide services to in-patients and out-patients from every clinical area within Gloucestershire Hospitals NHS Trust and also to private units and other Trusts, such as the mental health partnership trust. The dispensary service has a dedicated and motivated team of pharmacists, technicians and support staff who aim to deliver a seamless service to all our patients and other clients. We have one of the most up to date robot dispensing systems available at GRH and CGH sites which has complemented the one stop dispensing scheme (see Clinical Services section) and has aided a quicker turn around time for discharge prescriptions. The robotic dispenser has also cut down on repetitive box picking in the distribution area.

Members of staff you may come across if you visit the dispensary are: -

Pharmacists, Pre-registration Pharmacists, Pharmacy Technicians, Student Pharmacy Technicians and ATOs.

Contact Details

Cheltenham General Hospital

Opening hours: Mon – Fri 9am – 5.30pm, Sat 9am – 12.30pm (emergencies only)

Main contact number: – 08454 22 3025

Main dispensary number: – 08454 22 3029


Gloucestershire Royal Hospital

Opening hours: Mon – Fri 9am – 5.30pm, Sat 9.30am – 12.30pm (emergencies only)

Main contact Number: – 08454 22 5513

Main dispensary Number: – 08454 22 5509


Stroud General Hospital

Opening hours: Mon – Fri 9am – 5pm

Main dispensary number: – 01453 562262


Cirencester Hospital

Opening hours: Mon - Fri 9am - 1pm, 2pm - 5pm

Main dispensary number: - 01285 884563

Clinical Services

Our clinical pharmacy services focus on ward-based pharmacy teams providing a comprehensive service. Most wards have a pharmacist and a medicines management technician providing a daily service. Times of visits vary, and are arranged by mutual agreement. The level of service provided to each ward will vary across the specialties depending on divisional arrangements.

Specialist pharmacists attend consultant ward rounds. We have ward-based pharmacists and technicians on our Acute Medical Unit (MAU), medical, surgical and oncology wards. Technicians are also involved in supporting medicines management and patient safety initiatives.

POD (patient’s own drugs) lockers are on every ward and the majority of medicines are provided by our one-stop dispensing service which means patients receive a 28 day supply of medication on admission for use during their stay and at discharge. All of our ward technicians have a regional medicines management accreditation.

The Divisional Pharmacy links are key to our Clinical Pharmacy service. Each Division has a senior pharmacist responsible for promoting Medicines Management objectives in the division through liaison with the Medical Director, Divisional managers and Modern Matrons.

Our service is very much part of the multidisciplinary team and our contribution to patient care is well recognised and appreciated by the Trust. Divisional lead pharmacists are key members of many Committees in the Trust such as those for Infection Control, Audit and Clinical Effectiveness, Research, Ethics and Medication Safety.

• Going to Hospital 

Members of staff from the clinical pharmacy team that you may come into contact with whilst you are an in-patient are:

Clinical pharmacists and medicines management technicians.

Medicines Information

The Medicines Information service provides evaluated information and advice regarding all aspects of medicine use including:

• Treatment choices
• Adverse reactions to medicines
• Interactions between medicines
• Administration and compatibilities of injectable medicines
• Medicines dosing and administration
• Safety of medicines in pregnancy or breast feeding mothers
• Safety of medicines in impaired kidney or liver function
• Identification of foreign medicines
• Policies around the best use of medicines.

The information service is provided to doctors, nurses, pharmacists and other appropriate healthcare professionals. Information is also available to patients of Gloucestershire Hospitals NHS Foundation Trust via our medicines help lines (see below for contact details). Advice for patients and members of the public can be sought from NHS Direct on www.nhsdirect.co.uk or 0845 4647

The Medicines Information Service has been established for many years. Up-to date resources, information technology and professional expertise are used to provide evaluated information and advice to enquirers. Staff working within medicines information include pharmacists, pre-registration pharmacists and Senior Pharmacy Technicians.

Pharmacy Manufacturing & Technical Services

Cheltenham General and Gloucestershire Royal Hospital each have their own manufacturing unit. With Cheltenham focusing on Adult Oncology and Gloucester on TPN and Paediatric Oncology and non-sterile products.

The Pharmacy manufacturing units are involved in the preparation of medicines that are not available commercially in a ready-to-use format. The majority of this work is concerned with aseptic preparation. This is the preparation and supply of products that must be completely sterile before administration to the patient. In order for this to be achieved they are made within special isolators which are supplied with filtered air. The majority of aseptically prepared items are either Total Parenteral Nutrition (TPN) or chemotherapy.

TPN

These contain all the essential nutrients to sustain a patient if they are unable to eat food in the normal way. TPN bags containing carbohydrates, fats and salts in a 1.5 litre formulation are purchased. These standard bags then have vitamins, trace elements and extra minerals added as necessary.

Chemotherapy

Cytotoxic drugs are used in the treatment of cancer. They are supplied in a ready-to-use form to the ward which means that staff are not exposed to the toxic nature of the medicine. By working within the controlled environment of the aseptic suite the pharmacy operators are also protected whilst preparing the medication. A variety of devices are made (5-Fu Walkmeds / Accufusors) which means patients are able to complete chemotherapy at home, without a stay in hospital.

Extemporaneous Preparation

Whilst most medicines are commercially available, some dosage forms cannot be purchased from large companies. Extemporaneous preparation describes the work involved in supplying a medicine in a form or dose that is not otherwise available. The technical services departments across both sites are involved in the manufacture of:

• Liquid formulations
• Eye drops
• Creams
• Ointments

Quality Control

Deals with all aspects of quality control within the pharmacy manufacturing and purchasing sections. Advice is given on COSHH (control of substances hazardous to health), medical gases and complaints regarding faulty drug products and sundries.

Pharmacy Stores and Distribution

Cheltenham General and Gloucestershire Royal Hospitals both have their own stores and distribution departments.

The stores departments at both hospitals purchase and distribute all pharmaceutical products used in Cheltenham General, Gloucestershire Royal and Community Hospitals within Gloucestershire.
Some of their daily duties include:

• Ordering of all medicines
• Stock control
• Booking in medicines onto the pharmacy computer system
• Using electronic data interchange software to order from pharmaceutical wholesalers.
• Sourcing unlicensed medicines and chemicals from non-mainstream manufacturers and abroad
• Dealing with drug alerts to see if the Trust has received affected batches, recalling affected batches from the wards and processing the computer and paperwork for reimbursement from the suppliers.
• Investigating manufacturing problems and sourcing alternative stock.

Frequently Asked Questions by Patients

What do I do if my local pharmacist has difficulty obtaining medication started when I was in hospital?

Your GP will receive details of all the medication prescribed for you in hospital. Some community pharmacists may not be familiar with some of the specialist medication we use within this Trust. Should your local pharmacist have difficulty obtaining an item he/she can telephone our purchasing office for advice on 08454 22 3646 (Cheltenham General Pharmacy) or 08454 22 6191 (Gloucester Royal Pharmacy).

Can you dispense green prescription (FP10) forms that I get from my GP for me at the hospital?

No.

Can a Community Pharmacy dispense the Hospital White Outpatient Prescription?

No.

I am coming into hospital for treatment/surgery. Is there anything I can do to prepare?

If you have prior knowledge of you hospital admission, please bring all your regular medicines with you. This should include all prescribed tablets, any inhalers, eye drops or creams that you use, along with any items that you may buy from the pharmacy or health food shop. This assists doctors and pharmacists in ensuring all the doses and treatments are kept the same, and we can confirm with you exactly what treatments you are taking, or what has been discontinued. During your hospital stay these items will be used for you, assuring you of continuous care. We will return your medicines to you at discharge and replenish your supply if there is less than 7 days treatment left.

Is there anyone I can speak to with regards to my medication?

Whilst you are a hospital in-patient your ward pharmacist, who visits the ward regularly, will be pleased to offer you advice. You may also meet one of our medicines management technicians on the ward who are also able to offer support and information regarding your medication. Pharmacy staff aim to assist in any aspects of medicine-related problems; from supply and provision of medicines, aids to help you remember your medicines (such as tick charts) and information about the therapies and side-effects etc.

If you attend an out-patient clinic at either of the sites you can request to speak to a pharmacist when you have your medicines dispensed.

Patient information leaflets are available in most medicine packs with further information on the medicine.

If you have any further questions once you are at home you can telephone our medicines help lines on 08454 22 2805 (Cheltenham General Pharmacy) Monday to Friday 11am-12 midday, or 08454 22 6837 (Gloucester Royal Pharmacy) 10am-11am

How much medicine will I be provided with when I return home?

Outpatient prescribing: Typically we will give you a sufficient supply of medicines to last you 2-4 weeks, after which you should go to your GP for further supplies of medicines. The amount we supply may vary if you require a special course of treatment for a specific length of time e.g. antibiotics. In some cases you may have to return to us for your medicines each time e.g. hospital-based clinical trials, drugs needing specialised investigations or hospital-only medicines.

Accident and Emergency: A supply of up to 7 days is usually given.

Medicines to take home after a stay in hospital: Where appropriate, for new medicines prescribed, up to 28 days is supplied on discharge. For medicines you have brought in, if more than 7 days’ supply is left, no further supply will be made. It is important for medicines that you will be continuing with; you contact your GP for further supplies as soon as possible after discharge. A copy of your discharge prescription will normally be given to you to aid communication when you contact your GP (Please note: packs of the same medicines do differ if manufactured by different companies).

Who can I speak to should I have a problem?

Should you have any concerns about a dispensed medication please contact the department on 08454 22 3029 (Cheltenham General Hospital Pharmacy) or 08454 22 5509 (Gloucester Royal Hospital Pharmacy) where we can direct your question to the most appropriate person. If you wish to make a complaint, or wish to inform us of excellent service please write to: -