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FMD case study - Darlington Memorial Hospital
We visited Dan Hibell, Informatics Lead Pharmacist at Darlington Memorial Hospital (part of County Durham and Darlington NHS Foundation Trust), in February 2019, a few days after the Falsified Medicines Directive (FMD) became law. Darlington was one of the initial pilot sites for FMD implementation and was one of several trusts that helped NHS Digital produce a toolkit to support others in implementing FMD.
Preparing to go live with FMD
The team first registered online with SecurMed – a straightforward process followed by a wait of around two weeks for their registration to arrive in the post. In the meantime, they ordered suitable 2D barcode scanners. You cannot perform any FMD scanning without a registration number so it is important that you register as soon as possible.
The trust has different pharmacy stock control systems at two of their hospitals, with each also having their own medicine goods-in and pharmacy services. This meant that a standalone solution was most appropriate for them. The team reviewed all the available FMD systems on the market and chose the system created by Alex Jennings at Aintree University Hospital – the most cost effective in the interim period for their trust.
The team also looked into upgrading their pharmacy robot to be FMD-compliant but found that costs were high due to the age of the equipment. They have plans to replace it in the future with a new model that they will make sure is FMD-compliant to avoid manual scans.
Prior to go live, Dan also worked with his trust’s IT team as software needed to be installed on each computer that would have an FMD scanner attached. Firewall settings were also altered to enable connection to the National Medicines Verification System (NMVS).
Dan shared information about his preparations with other pharmacists and pharmacy technicians. This encouraged them to register early with SecurMed and reduced the time spent researching software solutions and scanners.
When and where verify and decommission takes place
Like many trusts, Dan decided to implement the verification and decommissioning scans at goods-in. Although this approach works best for the team, Dan does have concerns about extra work space and the additional burden on the goods-in team due to manual scanning, particularly as the volume of FMD compliant packs increases.
Volumes of FMD packs
The team is currently seeing a small amount of medication packs coming through that have a 2D barcode, safety features and have been uploaded to the NMVS.
Benefits of FMD
Patient safety is very important and, as FMD implementation increases, pharmacy teams and other clinicians can be sure that patients are not supplied with counterfeit medicines that have somehow entered the legitimate supply chain.
With the future addition of a new pharmacy robot, Dan expects around 90% of medicines received will be processed and scanned this way, vastly reducing the need for manual scans during the goods-in process. Exceptions requiring a manual scan will include controlled drugs, liquids in glass bottles and heavy or bulky items.
Dan also expects the FMD software will help the pharmacy team better manage expiry dates. At the moment, the team manually check and re-order shelves to make sure near-dated stock is as at the front and used first - a labour intensive process. With the introduction of FMD, staff will be able to check expiry dates of compliant stock at the touch of a button.
The stand-alone solution also keeps records of decommissioned medicines for two years, which could be helpful in the event of medicine recalls. The team has had had one major recall in the last year, but regularly has to deal with smaller recalls.
Wish list and the future
Dan is hopeful he will be able to provide enough staff resource to perform FMD scans, especially as the volume of compliant medicine packs increases. He expects the new robot will ease the burden as ore packs will be scanned automatically, with a hand scanner alongside to scan exceptions.
He would also like to see regular communications from SecurMed showing how many medicines are now recorded on the NMVS database. This would help to make the pharmacy more efficient when checking packs at goods-in to see if they are FMD-compliant, and would also help with planning for scaling up the scanning activity.