Community pharmacy practice

Community Pharmacy Practice
(UK)
15/07/2014 Ravina Barrett 1
Aimed to assist Pharmacy staff (Techs,
Pre-reg’s and Pharmacy Students) in ‘getting it
right’ in practice and for exams.

Aim and purpose
This unit provides the knowledge required to
assist in:
1. The supply of appliances,
2. Dressings and
3. Other non-medicinal products, and
4. The provision of services outside of the
pharmacy.

Unit introduction
This unit delivers knowledge and understanding
that can be used by learners involved with the
provision of community specialist services to
colleagues, clients and other healthcare
professionals.
The impact of the role of pharmacy within the
community healthcare environment is also
considered.

So…..What?
• Following completion of this unit, learners will know how
medication is supplied to care homes and the equipment
and documentation involved.
• Learners will acquire knowledge to assist in the supply of
appliances, dressings and other non-medicinal products
using standard operating procedures, ensuring that
payment for the product is processed as appropriate.
• The unit highlights the importance of correctly preparing
for the delivery of services outside the pharmacy, including
health and safety requirements, as well as the importance
of working at all times within the limits of one’s own role.

Learning outcomes (LO1, LO2, LO3)
1. Understand how to assist in the provision of
appliances, dressings and other non-
medicinal products
2. Understand how to assist in the provision of
services outside of the pharmacy
3. Know the national and local regulations and
policies regarding supply of medicines to
patients in care.

Prescriptions format and content
We will cover:
• Rx FP10
• Rx FP10 MDA
• Rx FP10 Token
• Exemptions
By the end, you should be
able to populate an empty
Rx template.
Homework:
Find the blank copy of the
Rx in your print-outs and
then fill it out for one pair
of hosiery.

(LO1) The provision of appliances, dressings and other non-
medicinal products
1. Wound management:
– Features of commercial wound
dressings;
– Primary and secondary dressings;
– External factors involved in wound
healing;
– Unconventional methods to aid wound
healing e.G. Maggot therapy, leeches,
herbal remedies
Maggot therapy - http://upload.wikimedia.org/wikipedia/commons/9/97/Maggots.jpg
http://ewma.org/fileadmin/user_upload/EWMA/pdf/EWMA_Projects/Debridement/EWMA_Debrideme
nt_Document_JWCfinal.pdf

Some topical stuff…
http://ewma.org/english/publications/position-documents/all-documents.html#c319
http://ewma.org/?id=243
*http://ewma.org/fileadmin/user_upload/EWMA/pdf/Position_Documents/2006/English_pos_doc_2006.pdf*

Group Homework on Wounds 
Groups to give a 5 min presentation
(with hand-out's which I can reprint
for peers) on 1 of the following 7
types of dressing and bandages
Describe the structure and
function of each & Give one
example of the following:
1. Alginate dressings
2. Foam dressings
3. Hydrocolloid dressing
4. Hydrogel dressings
5. Vapour permeable films
6. Odour absorbent dressings
7. Cohesive bandages
Deadline: Next Class
Individual Homework on
Wounds
Identify and describe the
physiological and external
factors that need to be
considered when assessing
wound healing.

Task: Label these Dressings using the types of
dressing and bandages category (slide 9).

Task: Label these Dressings using the types of
dressing and bandages category (slide 9).
Bring in samples if you can
so that we can share it
with peers in the class
room

Case Study
Mrs Nom-Nom-Nom, a 65 year old
lady has a leg ulcer that is
producing medium amounts of
exudate and is covered in a thin
layer of sloughy tissue.
She has swollen legs, has difficulty
walking and is overweight.
When you enter the PMR records
you also discover that she is taking
Metformin 500mg tabs .
Explain what type of
wound management
product and/or other
bandage you would
expect to be prescribed
and why giving an
example of specific
product(s).
What aspects of this
case do you consider
relevant to the healing
process?
Explain how you would
counsel this patient to
ensure effective use and
ongoing management.

medicinal products
2. Surgical hosiery
We will cover:
– Therapeutic use;
– Varicose veins;
– Measurement and fitting;
– Care and maintenance of products
– Take a look at the following link and watch the
demo video
http://www.activahealthcare.co.uk/compression-hosiery/

Endorsements and Prescription Pricing
of Hosiery
To price your prescription, NHSBSA Prescription Pricing Division
processing staff need sufficient information about the product
being dispensed. As a general rule, prescriptions for hosiery
should include information on the Compression Class, Article
style, Quantity and Knit.
1. <compression class>
2. <article style>
3. <quantity>
4. <knit>
5. If appropriate <made to measure>

Task: what is…?
1. Made to measure Elastic hosiery, explain how
this is different to regular Elastic hosiery.
2. Measured and Fitted , explain how this is
different to regular Elastic hosiery
3. Drug Tariff Part IXA - what characteristics of the
product does it detail?

Elastic (Knee) Support
• Elastic Support is not
the same as Surgical
hosiery
• This is effectively a
‘tubular bandage’
• Rx’s can look as basic as
this one

Surgical hosiery:
Be able to identify what is
essential info necessary on an Rx
and what bits of info you can
deduce/find out.
What needs to be endorsed?
Remember correct endorsement
is essential to your job!

Drug Tariff Technical Specification No 40.
(The number increments with the latest current version)
• Below (slide 19 – 22) we discuss relevant parts of
the DT.
• You need to know (or at least be able to look-up
when asked) the different classes of hosiery, their
indication, level of compression and style.
• What needs to be on Rx – see slide 17.
• Check out the accessories that can assist disabled
or elderly patients. Be able to recommend a
product and demonstrate its use/application.

ELASTIC HOSIERY Graduated Compression Hosiery, Specification 40
Explanation of Garments
N.B. The "Class" can be expressed either with roman or arabic numerals.
Class I Light (Mild) Support
Compression at ankle 14mm Hg - 17mm Hg
Indications - Superficial or early Varices. Varicosis during pregnancy.
Styles - Thigh length or below knee with knitted in heel
(reciprocated).
Class II Medium (Moderate) Support
Indications - Varices of medium severity
- Ulcer Treatment and prevention of recurrence. Mild
oedema
- Varicosis during pregnancy
- Anklets and kneecaps: for soft tissue support
Styles - Thigh length or below knee with knitted in heel
(reciprocated)
Class III Strong support
Indications - Gross varices
- Post Thrombotic Venous Insufficiency
- Gross Oedema
- Ulcer Treatment and prevention of recurrence
- Anklets and kneecaps: for soft tissue support
Styles - Thigh length or below knee open or knitted in heel
(reciprocated)15/07/2014 Ravina Barrett 19

General Notes
Prescribing
Before the prescription can be dispensed the following details must be given by
the prescriber.
1. Quantity - single or pair
2. Article including any accessories
3. Compression Class I, II or III
Constructional Specification
The complete structural specification, as well as performance requirements are
contained in Drug Tariff Specification No. 40.

Specially Made Garments
1. In cases where stock sizes are not suitable for patients owing to irregular limb dimensions, surgical stockings in the prescribed compression
class, to be made to the patient's individual measurements, should be specified.
2. All such garments are specially shaped during manufacture and may have a knitted in or open heel and open or knitted in toe.
Sizing
All articles must conform to BS 6612:1985 with regard to size designation.
Labelling
All articles must state clearly on the packaging that they conform with Drug Tariff Technical Specification No 40. The packaging should also
provide clear washing instructions in conformity with handwashing at 40°C as defined in BS 2747 and washing instructions should be durably
and clearly marked on each garment. The packaging should clearly define the garments percentage and fibre content.
DESCRIPTION OF ARTICLES AVAILABLE
Compression
Class
(See 253)
Type of Garment Standard Stock Sized
Garments
* Made-to- Measure
Garments
Knit Style Price per pair in pence Price per pair in pence
CLASS I Circular Thigh 799 4230
B. Knee 730 2646
Lt. Wt Elas. NetThigh 2140
B. Knee 1671
CLASS II Circular Thigh 1188 4230
B. Knee 1067 2646
Net Thigh 2140
B. Knee 1671
Flat Bed Thigh 4230
B. Knee 2646
CLASS III Circular Thigh 1408 4230
B. Knee 1210 2646
Flat Bed Thigh 4230
B. Knee 2646

All such garments are specially shaped during manufacture and many have a
knitted in or open heel and open or knitted in toe with the following exceptions:
Class II/III - Flat Bed Knit can only be supplied with closed heel and open toe.
For Above Knee Stockings - see Thigh
Length.
Accessories Price per item in pence
Acti-Glide 1428
Additional Price for Fitted Suspender 69
Arm Butler 800
Easy-Slide (application aid for open toe stockings) (S,M,L,XL) 1211
Easy-Slide Caran (application aid for closed toe
stockings)
(S,M,L) 1404
EZY-As compression hosiery applicator 3240
EZY-As compression hosiery applicator
handles
1525
Foot Butler 800
Magnide (M, L) 1404
Mediven 2 in 1 1233
Sockaid 1288
Spare Suspender for thigh stockings 69
Suspender Belt Drug Tariff Specification No. 13 532

Case Study: Mrs Kankles
Mrs Kankles brings a prescription into the
pharmacy for two pairs of thigh length,
class II stockings.
She tells you that this is the first time she
has had a prescription for these items.
Mrs Kankles has to pay for her
prescriptions.

Task: Mrs Kankles
1. Identify two conditions for
which thigh length stockings
could be prescribed.
2. State the information you
would give to Mrs Kankles
about her prescription
charges.
3. Describe how you would
measure Mrs Kankles to
establish whether standard
size hosiery could be used
by this patient.
4. Explain when would be the
most appropriate time of
day to take these
measurements.
5. Give two reasons why it is
important to take accurate
measurements.
6. According to the Drug
Tariff, state what
information is required on
the prescription before
elastic hosiery can be
dispensed?

Task: Mrs Kankles
7. Describe how you would
correctly fit Mrs K's
stockings. This link may
help
https://www.youtube.com/watc
h?v=Cvuziq5qS0U
8. Explain how you would
ensure that Mrs Kankles
has fully understood the
information given to her
about her stockings
10. Explain any additional
advice you would give
concerning care and
maintenance of the hosiery
and any other problems a
patient may encounter.
11. Explain how to endorse
Mrs Kankle’s prescription
12. Explain how to submit the
prescription to the
appropriate authority at
the end of the month.

medicinal products
3. Stoma care:
– Reasons for use of urostomy,
– Ilieostomy and colostomy;
– Care and maintenance;
– Management and supply of ostomy products and
accessories

Accessories
Cleansing Solutions Disposal Bags

Urostomy
A urostomy is a stoma for the urinary system. A
urostomy is made to avail for urinary diversion
in cases where drainage of urine through the
bladder and urethra is not possible, (e.g. after
extensive surgery or in case of obstruction).
http://en.wikipedia.org/wiki/Urostomy
Extra Reading (even if you look at the pix)
http://www.cancer.org/acs/groups/cid/documents/webcontent/002931-pdf.pdf
Images: http://tinyurl.com/qar76w8

Catheter

Urine Bag
Urinary Collection Bag - Front Urinary Collection Bag - Back

Ben & Jerries, Strawberries & cream…
Catheters &…?
Male Catheter …….. Lubricating Jelly

Ilieostomy / Ileostomy
noun: ileostomy; plural noun: ileostomies
A surgical operation in which a damaged part is
removed from the ileum and the cut end
diverted to an artificial opening in the
abdominal wall.
Video: http://www.nhs.uk/conditions/Ileostomy/Pages/Introduction.aspx

Colostomy
A surgical operation in which the colon is
shortened to remove a damaged part and the
cut end diverted to an opening in the abdominal
wall.
Video (End Colostomy): http://www.youtube.com/watch?v=zXjQ7MjinTQ
Images: http://tinyurl.com/qglhfab

Colostomy Rx & Product
Moderma flex colostomy bag
42300
http://www.hollister.com/anz/news/news_di
splay.asp?newsid=5&id=1

http://www.hollister.com/anz/news/large_photo.asp?id=1&photo=4162012171038.jpg
How the AF300 Ostomy Filter works:
• Gas build up and ballooning are
reduced through enhanced airflow of
the filter.
• Better odour control occurs through the
use of a exclusive, activated carbon that
also extends the effective life of the
filter.
• Provides continuous venting, allowing
gas and air to escape unnoticed.
• Liquid cannot penetrate the filter from
the inside or outside as it is protected
by a specially designed film barrier.
• No more filter covers mean you can
confidently wear any Moderma Flex or
New Image pouch while bathing,
swimming or taking part in other forms
of active lifestyle.
Available on all Closed and Drainable
Pouches with Lock ‘n Roll Closure. The filter
gives you confidence and convenience.
Hollister AF300 Filter
1. The filter includes an impressive
300 mm2 surface area that
promotes enhanced air flow.
2. In addition, a patent pending
configuration, GORE* Medical
Membranes and activated carbon
make the Hollister AF300 filter a
durable filter.

Homework
1. Produce a table listing a range
of products and accessories
suitable for a new ostomy
patient either colostomy,
ileostomy or urostomy.
2. Identify at least two conditions
that may have resulted in the
patient requiring the ostomy.
3. State the information needed
by your patient regarding
prescription charges.
4. From your table above, describe
the function of at least two
types of ostomy bags and three
of the accessories you have
identified for this patient.
1. Explain how the patient obtains
further supplies of these
products.
2. Explain any advice you could
give to this patient to prevent
problems with sore skin around
the stoma area, including any
advice on diet, taking
medication and other relevant
lifestyle issues.
3. Explain how the pharmacy
could review and advise this
ostomy patient about their
needs and the importance of
maintaining information on
PMR.

medicinal products
4. Continence care (http://www.patient.co.uk/health/urinary-incontinence-leaflet):
Causes of incontinence
a) Stress incontinence - when the pressure in the bladder becomes too
great for the bladder outlet to withstand. Caused by weak pelvic floor
muscles (childbirth). Sudden extra pressure (stress) inside the tummy
(abdomen) and on the bladder. Pelvic floor muscles are often weakened
by childbirth. Stress incontinence is common in women who have had
several children, in obese people and with increasing age. Stress
incontinence can occur in men who have had some treatments for
prostate cancer. This includes surgical removal of the prostate
(prostatectomy), and radiotherapy.
http://www.patient.co.uk/health/stress-incontinence

medicinal products
4. Continence care
b) Urge incontinence/idiopathic urge incontinence (unstable or overactive
bladder) is the second most common cause. Urgent desire to pass urine,
which leaks before you have time to get to the toilet. The bladder muscle
contracts too early and the normal control is reduced. Cause: problems
with the nervous system (the brain, spinal cord and other nerves in the
body). Illnesses or diseases affecting the nervous system are called
neurological disorders. Some people with certain neurological disorders
may experience urge incontinence. Examples are Parkinson's disease,
multiple sclerosis (MS), spinal cord injury and after a stroke.
a) http://www.patient.co.uk/health/urge-incontinence
b) http://www.patient.co.uk/health/overactive-bladder-syndrome

medicinal products
4. Continence care (http://www.patient.co.uk/health/urinary-incontinence-leaflet):
c) Mixed incontinence (stress and urge).

medicinal products
4. Continence care
b) Treatments, (non-medical)
• http://www.patient.co.uk/health/urinary-
incontinence-leaflet

medicinal products
4. Continence care
c) Treatments (medicinal, Available products)
Medicines called antimuscarinics (anticholinergics):
– Oxybutynin (Cystrin®, Ditropan®, Lyrinel® XL and Kentera®)
– Solifenacin ( Vesicare®)
– Tolterodine (Detrusitol®)
– Trospium chloride (Flotros®, Regurin®, Uraplex®)
– Propiverine (Detrunorm®)
– Flavoxate hydrochloride (Urispas 200®)
– Darifenacin (Emselex®)
– Fesoterodine fumarate (Toviaz®)

NHS Repeat Dispensing
See other notes
Also known as:
• Repeat Dispensing
• Repeat Prescription Service
• Batch Dispensing
Not to be confused with ‘Repeat Prescription
Collection Service’ or PCS which is a free service
provided by pharmacies to build ‘regular business’
and secure their business.

Homework
What is a repeat
prescription service?
Give two examples of
patients who might
benefit from these
services giving your
reasons.

Home Delivery Service
There are professional and
practical considerations that
are important when deciding
whether or not to deliver
medicines or whether or not
to post medicines (prescribed
or sold) to patients.
Consider the following when
making a professional
judgment (The list is not
exhaustive)
• Patient consent for
delivery or posting
• Patient confidentiality
during the delivery or
posting process
• Whether it is necessary
for face-to-face contact
with the patient to ensure
that the medicine can be
safely, effectively and
appropriately used

Home Delivery Service
• Whether it is necessary to
interview the patient
• Whether the patient has
been assessed or directly
interviewed by the
prescriber
• An adequate audit trail for
delivery and receipt from
the point at which the
medicine leaves the
pharmacy and is received by
the patient (or returned to
the pharmacy in the event
of delivery failure)
• Storage requirements
during transit
• When posting – will the
postal carrier agree to
transport the medicinal
product (check terms of
carriage, prohibited and
restricted goods)

Delivery of sch 2 or 3 controlled drug
Legislation requires that a requisition in writing must be
obtained by the supplier before delivery of any schedule 2 or 3
controlled drug to most recipients including practitioners,
hospitals, care homes, ship and offshore installation personnel,
supplementary prescribers, senior registered nurses in charge of
wards, theatres and other hospital departments.
Some recipients (such as other registered pharmacies) are not
included in this legal requirement. However, for audit purposes,
and as a matter of best practice, we would advise that supplies
should only be made after receiving a written requisition.

Delivery of sch 2 or 3 controlled drug
Therefore, where one registered pharmacy
supplies another registered pharmacy, as a
matter of good practice, a requisition written on
a standardised form should be obtained.
A representative, including a delivery driver, can
sign on behalf of a patient. However, a robust
audit trail should be available to confirm
successful delivery of the medicine to the
patient

When posting abroad
When posting abroad – are there legal restrictions in the
destination country which would prevent you from posting?
For example, guidance produced by the U.S. Food and Drug
Administration (FDA) makes it clear that it is illegal or a foreign
pharmacy to ship prescription medicines that are not
approved by the FDA to the United States)
„„
When posting abroad – are there UK legal restrictions which
would prevent you dispensing in the first instance?
(e.g. is the prescriber recognised as an appropriate
practitioner (see 3.3.1) for the medicinal product in the UK?)

Case Study
Mr Cough-a-lot
is 55 years old is an asthmatic
and regularly visits the local
pharmacy to obtain his
prescriptions. His usual
prescription includes inhalers,
blood pressure tablets and
cholesterol tablets. He has
discussed using the repeat
dispensing service with his GP
and would now like to use this
service
1. Explain to Mr Cough-a-lot the
information you need from him
to implement this service and
explain what he needs to do
next time he needs more
medication.
2. Explain what records need to
maintained by the pharmacy of
this service.
3. Explain the patient safety issues
that might be identified by the
pharmacist concerning patient’s
medication or condition that
could suggest that it was unwise
to dispense the repeat
prescription.

Homework
What is a delivery service?
Give two examples of patients
who might benefit from these
services giving your reasons.
Mr Cough-a-lot has arranged for
his medication to be delivered to
his home in future.
If Mr Cough-a-lot was not at
home to receive delivery of his
prescription and the delivery
personnel asked if the package
could be posted through the
letterbox or left with a neighbour,
explain what you would instruct
them to do.
Give reasons for your
instructions, stating your
professional and legal
responsibility when providing
medicines via a delivery service.

medicinal products
5. Inhaler devices:
– Technique to use;
– Care and maintenance

Inhalers (MDS)
Source:
http://www.asthmasymptoms86.com/asthmainhaler.html#.UrMTmNJdV44

Different potencies of CFC-free
beclometasone inhalers
Qvar and Clenil Modulite▼ are CFC-free pressurised metered-dose inhalers
that contain beclometasone diproprionate. They have different potencies
because of their different formulations, which may have implications for both
safety and efficacy. Qvar has extrafine particles, is more potent than
traditional CFC-containing inhalers, and is about twice as potent as Clenil
Modulite▼.
Advice for healthcare professionals:
1. Prescribe CFC-free beclometasone metered-dose inhalers by brand
name to reduce the risk of dosing errors
2. Pharmacists are reminded that for any generic prescription for
beclometasone, they should establish whether a CFC-free product is
required and if so, which brand should be dispensed
3. Clenil Modulite▼ may be used in children (with the Volumatic spacer
device) and adults; Qvar is not recommended for use in children
MHRA (Drug Safety Update) http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON085179

CFC-free beclometasone and
formoterol
Fostair▼ is a CFC-free, fixed-dose combination of
beclometasone and formoterol, which is licensed for the
management of asthma in patients aged 18 years or older.
Similar to Qvar, Fostair▼ contains an extrafine formulation of
beclometasone and is more potent than traditional CFC-
containing beclometasone inhalers.
Advice for healthcare professionals: The inhaled-corticosteroid
component of Fostair▼ is about twice the potency of traditional
CFC-containing inhalers, which should be taken into account
when switching patients from a non-ultrafine preparation. The
dose of beclometasone dipropionate in Fostair▼ should be
lower than non-extrafine formulations of beclomethasone
dipropionate and will need to be adjusted to the individual
needs of the patient. MHRA (Drug Safety Update) http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON085179

Handihaler (Spiriva only)
Video:
http://www.youtube.com/watch?v=bXHHFmZ_
DRI

Spacer Device
Source: http://www.daaat.org/inhaler-devices.html

Spacer Device
• Spacers should not be regarded as
interchangeable: patients who use a spacer with
their inhaler should use the spacer device named
in the Summary of Product Characteristics (where
specified by name)
• Patients whose asthma is well-controlled and
who are using a spacer should always use the
same type of spacer and not switch between
spacers. Different spacers may deliver different
amounts of inhaled corticosteroid, which may
have implications for both safety and efficacy
MHRA (Drug Safety Update) http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON085179

FURTHER INFORMATION
• RPS Support Medical Devices – quick
reference guide. 2012. (www.rpharms.com)
• MHRA. Information on regulation of Medical
Devices (www.mhra.gov.uk)

medicinal products
6. Compliance aids:
Available products and their use
e.g. Dossette boxes

medicinal products
7. Correct documentation and record keeping:
• Electronic and paper;
• Patient medication records (PMR’s);
• Endorsement,
• Processing payment

medicinal products
8. Use of resources:
drug tariff, products allowed on prescription;
appropriate endorsement; different types of
prescriptions; prescriber formularies

(LO2) Understand how to assist in the provision of services
outside of the pharmacy
1. Communication skills:
– Identifying the needs of others;
– Confidentiality;
– Questioning,
– Listening,
– Sensitivity

2. Services:
– Collection and delivery service,
– Collection of prescriptions;
– Delivery of dispensed items;
– Domiciliary visits;
– Standards operating procedures (SOPs);
– Guidelines in code of ethics;
– Legal and ethical requirements for patient
safety15/07/2014 Ravina Barrett 63

3. Health and safety:
–Personal and product safety
4. Correct documentation and record keeping:
–Manual,
–Electronic

MDS - Homework
1. State two types of
patients who would
benefit from having their
medication dispensed in
a monitored dosage
system.
2. State two benefits the
patient would receive
from this service.
3. State one reason for
implementing a
monitored dose system
in a care home.
4. Identify and describe
two different dosage
monitoring systems
currently available.
5. Describe five practical
problems of using a
monitored dosage
system in a care home
and difficulties that may
arise with storage of
some medications within
these systems.

(LO3) Know the national and local regulations and policies
regarding supply of medicines to patients in care
1. Monitored dosage systems:
–Different products available;
–Purpose for use;
–Dispensing and labelling;
–Difference between compliance aids and
MDS

2. Documentation:
–Medication Administration Records (MARs);
–Manual and electronic record keeping;
–Prescriptions;
–Endorsement

3. Regulation and policy:
–National Standards;
–Medicines, Ethics and Practice guidance;
–Audit (external, internal);
–SOPs

4. Unused medication:
–Returned medication;
–Registered nursing homes,
–Residential care homes
The Handling of Medicines in Social Care
http://www.rpharms.com/support-pdfs/handling-medicines-socialcare-
guidance.pdf

Nomad Boxes (Nomad® Concise)
1. Saves more space
2. More effective if using less than 5 items.
3. Manage your medication more effectively.
4. One tray per week.
5. Each day has four separate times for medication including morning,
afternoon, evening and night time so taking your medicine is easier
6. NOMAD Backing Sheet explains the medicines in the box/tray
7. Tamper evident
8. Reduces the ingress of moisture
9. Can be Compliant to some standard (e.g. US Pharmacopoeia grade B)

BENEFITS OF MDS IN CARE HOMES
• Significantly reduce the time taken for administering
the medication (Blister Packed medication)
• It can hold up to 7 days’ worth of medication for up to
6 doses per day
• The Nomad® system can be easily rendered tamper
evident
• The combination of insert tray and seal protects the
medication
• One compact unit means that storage is easy
• Image search: nomad system medication

• ‘P’, ‘M’, ‘D’ questions below represent the level of
‘Pass’, ‘Merit’ and ‘Distinction’ score each
question can attain.
• Prepare for this exam! This unit separates the
noobs from the grafters.
• Why? because having to look-up every little detail
will cost you time and marks on the day of the
exam.
• Know your stuff and you will breeze the exam
AND dispensary life like a PRO!
Exam Preparation

Exam Preparation
• P1 explain how to prepare for the supply of appliances,
dressings, and surgical hosiery, meeting individual and
prescriber requirements
• P2 explain the information required by an individual or
healthcare professional when supplying appliances,
dressings and surgical hosiery
• M1 categorise different types of dressings and surgical
hosiery
• D1 explain factors to be considered when choosing an
appropriate product

Exam Preparation
• P3 explain how to prepare for and deliver a service to
individuals that are unable to attend the pharmacy
• P4 describe health and safety risks when delivering services
• M2 discuss how risks to personal and product safety can be
minimised when delivering a service outside of the
pharmacy
• D2 evaluate a service delivered outside of the pharmacy
including the suitability of clients

Exam Preparation
• P5 describe the regulations and policies for the supply of
medicines to care homes
• M3 explain the responsibilities of individuals involved in the
supply of medicines to care homes
• M4 compare different types of Monitored Dosage Systems
• P6 describe the use of Monitored Dosage Systems
• D3 explain how to plan for the supply of medicines to a
care home

Community pharmacy practice

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