CPD ZONE CLINICAL CLINICAL PRACTICE 16 Travel health 18 Herbal meds 19 Ethics BUSINESS BUSINESS 20 C+D Senate 30 Category M ETHICAL DILEMMA This series aims to help you make the right decisions when confronted by an ethical dilemma. Every month we present a scenario likely to arise in a community pharmacy and ask you to comment on the legal and ethical implications of the actions open to you. We will share the best comments along with expert legal advice. Join the debate at www.chemistanddruggist.co.uk/practice How to overcome language barriers in your pharmacy The dilemma You are the responsible pharmacist (RP) of an inner city pharmacy that serves a large ethnic population. Aware that many of your patients do not speak English, you have recruited a member of staff who is fluent in Bengali. This assistant has proven a very enthusiastic addition to the team, and has passed her MCA training course. However, a few occasions have given you cause for concern over advice she gives to patients. You do not speak Bengali, and cannot supervise the advice given. As the RP, what steps should you take to monitor the quality of information given to patients, and ensure company SOPs are followed? Your views We asked for your views – and it looks like you were stumped on this tricky dilemma. We received no responses from pharmacists to the question. Instead, we contacted organisations to get you expert advice on what you should do in this situation. “It is the responsibility of the responsible pharmacist (RP) to ensure that any advice given to patients is correct and within their scope, meeting all SOPs in place. “Although support staff will have met (or are working towards meeting) the relevant minimum training requirements to work in a pharmacy, there is always an opportunity to identify further development needs. “While the MCA is undergoing this training, the RP could suggest that they act as a translator in conjunction with the pharmacist rather than providing independent advice themselves. “The RP should then conduct regular appraisals Next month’s Ethical Dilemma A dose dilemma Share your thoughts on the next dilemma at www.chemistanddruggist.co.uk/practice with the staff member to monitor their progress and to reinforce company SOPs.” Leyla Hannbeck, head of information at the National Pharmacy Association The General Pharmaceutical Council declined to comment The legal advice It is the duty of the responsible pharmacist to secure the safe and effective running of the pharmacy business, including the sale and supply of pharmacy medicines. The RP must ensure that there are procedures in place to secure this. These procedures, commonly known as SOPs, must be established, maintained and reviewed by the RP. It is not clear why cause for concern has arisen in relation to the advice that the assistant has provided in this case, nor is it clear what the company’s SOPs provide in these circumstances. Poor communication may carry significant clinical consequences, but it must be something more than the RP simply not understanding the language being spoken that raises concerns here. You must be able to rely on your qualified staff until some other factors give you cause for concern – perhaps a confused looking or upset patient, or a patient returning to the pharmacy to discuss a problem with their medication or raise a complaint. There are often no clear-cut cases in situations faced by an RP in practice, but the RP is ultimately responsible and must determine whether, after following the company’s SOPs, the circumstances still justify his or her intervention. SOPs are there to safeguard patient safety but are not failsafe, and the RP must exercise their professional judgement in the interests of the patient and be able to justify the action taken. If there are genuine causes for concern, then the issue should be raised and discussed with the assistant before determining what, if any, further help or training may be required. It is also worth noting that the company’s SOPs may not have specifically dealt with such an incident and it would therefore be appropriate for the RP to review the relevant SOP and notify the relevant person in the position of authority. Neil Jones is an associate solicitor at Ansons LLP CPD Reflect • Plan • Act • Evaluate Tips for your CPD entry on ethical decisions REFLECT What would you do if faced with this dilemma? PLAN Consider your current practice, and the advice offered in this article. ACT Draw up a plan of what to do if this dilemma occurs. EVALUATE Can you justify the decision you would make in this scenario? 25.06.11 Chemist+Druggist 19