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Dispensary Services QualityScheme (DSQS)
Dispensing Staff CompetenciesDevelopment Workbook
• Customer Service• Teamwork• Health & Safety
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About this Workbook
As part of the changes to the arrangements for dispensing doctors, agreed as part of the General Medical Services changes in 2006,a Dispensary Services Quality Scheme (DSQS) has been developed, which rewards Practices for providing high quality services totheir dispensing patients.
One criterion to be met by Practices to enable them to benefit from the rewards offered under this Scheme concerns dispensing stafftraining and experience. The key points of this criterion are that
Each Practice should consider the training and experience required by all staff who work in the dispensary; it needs toprovide evidence that all staff working in the dispensary have the competencies and knowledge to perform the tasks androles assigned to them.
Staff should not work unsupervised in the dispensary unless they have the required experience and competencies.
This workbook has been designed to provide a user-friendly and flexible means for dispensing staff to gain competence in the areasof Customer Service, Team Working and Health and Safety to complement study for S/NVQ qualifications. It provides a learningapproach, which can be successfully pursued through private study. SmartPractice Ltd is available to lend support where a traineewishes to clarify any aspect of the Workbook’s content or extend their competence in any of the three areas beyond the specificationin the Scheme, through further learning.
The look and feel of the Workbook is fresh and modern, supported by lots of relevant images and, wherever possible, encouragesyou to think through the issues posed and apply the learning directly to the context of your dispensary. The Workbook is a personallearning log and journey. You may share your thinking with others in your team should you wish but the emphasis is on raisingawareness, adding knowledge and encouraging you to question, assess and record personal behaviours, motives and emotions in away in which you may not have done before.
The content has been developed from established concepts and thinking in each of the three areas and with the assistance ofexperienced dispensing and practice professionals. Examples are therefore drawn from the real dispensing world although the theorymay apply to situations outside that territory. Acknowledgement and thanks are extended especially to the staff and PracticePrincipals of Cropredy Surgery and in particular to Mrs Kate Smith, Dispensary Manager at that Practice, for their time and assistancein developing many aspects of this Workbook.
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Assessment and Certification
SmartPractice has set up an on-line evaluation programme, which is accessible after completion of the Workbook. We will then issuean approved Certificate of Competence for each Registered User who is successful in the assessment.
Each Workbook is intended for the use of one trainee only. Assessment is by means of the above evaluation programme, access towhich will be authorised by the unique registration number supplied below. When you have completed the workbook, go towww.smartpracticeltd.com and follow the directions to the assessment process
Ownership
This workbook is issued to
Name
Name and address of Dispensing Practice
Registration Number
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CUSTOMER SERVICE
“You are serving aCustomer not a lifesentence. Learn howto enjoy your work”
Laurie McIntosh
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Customer Service - Coverage
At the end of this module of the Workbook, dispensers will have a heightened knowledge and awareness of thefollowing:-
• The nature of their customers, both internal and external.
• The importance of organisational policies and procedures relating to patient service and why they should befollowed.
• Their role in developing and maintaining patient relationships and their contribution to retaining patient loyalty andconfidence.
• How to identify, understand and meet patients’ dispensing service needs.
• How to understand the needs of difficult customers and patients.
• How to deal with customers and patients with varying needs, including special needs, in different situations.
• What information to provide to patients in a dispensing service context, and its sources.
• The importance of the organisation’s complaints procedure.
• The nature and importance of basic communication skills including speaking, listening, writing and reading.
• Basic telephone handling techniques • Checking understanding• How to take messages efficiently and effectively • Non-verbal communication• Dealing face to face with customers • Barriers to effective communication• Providing clear and accurate information • Effective reading and writing
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• How best to deal with conflict, difficult situations, difficult working relationships and situations characterised bystress and anger.
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Customer Service Module Subject Guide
Subject PageIntroduction – Giving great service to your Customers 6Your Customers – the Patient, internal customers, other customers 7Policies and procedures for dealing with your dispensary’s customers 8What do your patients want? 10The patient ‘experience’ 11Your attitude – the things you do and say 16Your customer service skills 17Customer service processes 19Dealing with the special needs of patients 22Providing information to patients 22Dealing with difficult and angry patients 23Reactions of angry patients 26A strategy for dealing with angry patients 27Handling complaints 31Outline of basic communication skills 34Listening 34Assessing your listening skills 35Tips on effective listening 36Body language 40Talking 42Assessing your preferred communication (talking) style 43Improving how you deliver your message 48Communicating positively 51Using the telephone 52Messaging from the telephone 55Tips on writing effectively 56Tips on reading effectively 57Barriers to communication 58Summary of learning 60Your action plan 61
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Introduction
This workbook is aimed at you as a National Health Service professional and specialist in dispensing services. I hope you will indulge us if, for the
purpose of emphasising our learning points about service, we use the shorthand term Service Giver, when we refer to you and others involved
in delivering service. We usually refer to your service organisation as your Practice.
Throughout this workbook, we also regularly use the term ‘customer’. You will obviously be more familiar with the term patient as, indeed, people
in other organisations may be more comfortable, for example, with terms such as patrons, guests, clients, passengers, users and shoppers as
people who buy or ‘consume’ services or goods. We will try as much as possible in the workbook to use the word patient as being the most
appropriate term for your dispensing customers although, as you will learn, there are a variety of people to whom you provide a service of some
kind in the course of your work.
Giving Great Customer Service
Over the last two decades we’ve moved from a nation that has depended on a manufacturing economy to one
where the ‘service economy’ is now the driving force behind its wealth.
This has focused the minds of those responsible for creating this wealth on the importance of the customer, what an
individual customer requires and how those needs can best be satisfied. This has led to the realisation that two
things will determine how customers can be satisfied and remain satisfied with the service delivered.
1. Having an overall approach or ‘process’ that defines how every customer’s needs are dealt with by the organisation as speedily and
efficiently as possible.
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2. The experience and positive attitudes of the service givers and how they consistently bring excellent skills to bear in making the ‘customer
experience’ welcoming and productive.
The External Customer
These, of course are the patients or their representatives with whom you meet and interact on a daily basis.
The Internal Customer
These are your work colleagues within your Practice with whom you may interact every day to some extent.
Other People who may need your service.
There are people who have some need regularly to seek service from you in their course of their own work. These might include, for example,
representatives of drug wholesalers, pharmaceutical industry representatives, PCT officials, hospital consultants and doctors, nursing home staff
and colleagues from neighbouring practices. You may sometimes find it distracting to be drawn away from your daily routines by people in this
group. However, they remain people who not only can add value to the quality of your dispensing service, but will take an impression of your
Practice away with them, and may even be a patient with your practice at some point in the future.
It will help at this point to identify just what your own network of customers looks like. In the case of patients, it might
be obvious but when it comes to your internal contacts and others, perhaps it is not so evident.
Cast your mind over your daily routine and make two lists of those with whom you come into contact at work on aregular basis. This may be face-to-face, over the phone or even by email. Make sure you identify everybody,especially the ‘difficult’ people! Think how good your relationships are with each and make a note beside each. Youwill not have to share your thinking with anyone else unless you want to.
E for Excellent relationshipG for Good relationship
Activity
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Good policies and procedures set out theparameters of reasonable service. Aquality service giver will take time tounderstand what these are.
OK for Satisfactory relationshipD for Difficult relationship.
My Internal Customers
Colleagues E, G OK or D Others E, G, OK or D
This is going to be important as we look at the further stages of developing great customer service.
Policies and Procedures for Dealing with Dispensary Customers
Let’s start by being realistic. As an example, how many of us find, that reading the ‘Customer Charter’ taped up on the supermarket wall makes
the checkout queue any more bearable? How many find that the smiling hotel receptionist makes you feel any less irritable if it’s taken you twenty
minutes to pay your bill at the checkout?
Words and good intentions, important as they are, will never make up for inefficiencies or flaws in an organisation’s
attitude to and basic philosophy around customer service. If, for instance, there are
too few staff to handle customers effectively or there are misunderstandings between
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departments or colleagues about who is doing what for patients, these and other inadequacies will hinder the best intentions of service-minded
people. However, having an overall documented approach and standards about quality of service, is important for all organisations, including your
Practice. Provided that the organisation is true to and acts on such policies, it gives all those involved in providing service to the patients some
direction and support for their behaviour and puts their actions in context.
What does this mean in reality?
Your Practice and your dispensary, just like any other service organisation has to maintain a balance between its own needs and those of your
patients. To meet all the needs and demands of your patients would almost certainly simply be impossible and put unnecessary stress on
everyone involved. Good policies and procedures set out the parameters of what is reasonable and desirable service. A
quality service giver will take time to understand what these are and use them to guide his or her actions and response.
Effective staff also realise something else that is very important. They know that it is their job to understand and follow
established policies and procedures and, on the occasions that it sometimes necessary, will use their knowledge, tact and
judgment to refer problems to others with a higher level of decision making authority where there is any ambiguity. This is
not ‘passing the buck’. This is demonstrating that you understand what the rules allow you to do and, provided you act
quickly and decisively, can often prevent issues with patients and portray a Practice that knows how to act properly. For
example, there may occasionally be a temptation to use your years of accumulated knowledge as a dispenser to make simple, routine medical
decisions about for instance, the kinds of drug a patient needs. The proper course of action would, of course, be to refer any judgment like that to
a GP.
So, as an effective-service giver in your Practice, you will make it your business to understand as much as you can about how the Practice
operates and what its standard operating procedures (SOPs), processes and standards are. With such an understanding, you can carry out your
responsibilities that bit more effectively.
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Activity
What are the key standards and rules concerning customer service in your dispensary? Make a list here and if you are unsurediscuss it with your Manager or the Practice Manager.
Examples
Developing and Maintaining Customer Relationships
Identifying and Meeting Customer Needs - What do your Patients want?
What exactly are the needs of those you serve? This for many organisations is the ‘sixty four thousand dollar question’ and why many companies
and other service organisations spend much time and money trying to understand them through activities and events like customer forums,
market research and questionnaires.
Different organisations have come to different conclusions about the things that are really important to their customers. It may not surprise you to
learn, for example, that customers of casinos have different needs to customers getting their cars serviced at garages and these are likely to be
different from the needs of people to whom you provide dispensing services. However, we have to recognise that most of these organisations are
striving to create some kind of unique experience for their customers that will ensure their continuing patronage and loyalty. We must also accept
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Activity
that it is possible for individuals to be customers of all the mentioned service organisations and that there are some things that are common to all
these situations.
Think about the different service situations that you encounter in a typical month. These could have been as a retailshopper or a passenger on one of our transport systems or, indeed as a patient at a hospital or GP practice. Re-live someof your recent service experiences and write some words that represent what you wanted and what you got in thosesituations
What I wanted What Iexperienced
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Activity
The Patient ‘Experience’
Putting yourself in the place of a service receiver will probably have led you to realise that are many things that can contribute to the serviceexperience being a good or poor one. We can boil these down to seven key customer needs. Consider each of theseven needs below and then make some notes about how this applies to your dispensing service. How might it workto your disadvantage but, more importantly, how can you make it work to your advantage?
1. Control
To some extent we all need to feel that we are in control of the situation. We like to feel that we canmake things come out our way and that we are not being taken advantage of, manipulated or deceived.
Any Problems? How Can We Change?
2. Fairness
One of our strongest drives as Customers involves a sense of fairness. We like to feel that in any service transaction we are being treated fairlyand appropriately when compared with others.
Any Problems? How Can We Change?
3. Friendliness
As Customers, any of us would prefer to feel good about those with whom we are interacting - we want to trust them and haveconfidence in them. We like service givers to be friendly and warm so that we can enjoy our dealings with them.
Any Problems? How Can We Change?
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4. Understanding
We always like to know what is happening and why. If we can’t understand what’s going on around us, we get frustrated and angry andespecially so if we are given no information or explanation to help us understand. How many times have you sat on a train or plane fuming at anunexplained delay?
Any Problems? How Can We Change?
5. Security
Generally, we have a strong need to feel safe and secure. Most of us like predictable situations where we are familiar with things andknow what’s going to happen. This may be why we often hesitate to change service providers or products. Many of us also getapprehensive if we think our safety or security is threatened.
Any Problems? How Can We Change?
6. Belonging
Many of us like to identify with organisations in many aspects of our day-to-day lives. We have strong urges to collaborate andassociate in clubs and other groups with shared purpose. It is no different in our roles as customers. We enjoy being identified aspeople who belong to the same group and the feeling of being a ‘regular’.
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Any Problems? How Can We Change?
7. Honesty
Customers and especially patients have a strong need to trust and have confidence in service givers. This need has grown inrecent years, perhaps because so many of us have been victims of false advertising, broken promises and generally shabbyservice.
Any Problems? How Can We Change?
[The above framework derived from The Art of Giving Quality Service by Mary Gober and Bob Tannehill]
It is a sobering thought that most of us as service receivers tend to form an impression about a service organisation, often through service givers
such as yourself and the facilities that they experience, in just seven seconds of contact! In that time we will come to three simple conclusions.
We either like you, we dislike you or we are indifferent towards you. Clearly, the first of these outcomes is by far the most desirable and
productive in terms of what it may mean for developing a long-term positive relationship with the customer.
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Activity
So what do your observations add up to and have you come to any conclusions about the challenges you face in your dispensing role inaddressing the needs of your customers and meeting the seven-second rule? Using some of your notes above, list below some of the positive
things about, for example, attitude and environment which you personally can influence in helping to create the rightimpression.
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TEAMS & TEAM WORKING
None of us is assmart as all of us
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Teams and Team Working - Coverage
At the end of this section of the Workbook dispensers will have a heightened knowledge and awareness of thefollowing:
• The key responsibilities of the Team
• Their role in the Dispensing Team and in the wider Practice Team
• Limitations of their role
• The key members of the Team
• The Dispensing Team’s contribution to the work of the Practice
• The importance of contributing effectively to the Team and in particular
• Communication with other Team Members • Establishing and developing good workingrelationships
• Supporting the Team and helping others in theirwork
• Problems with teams and how team dynamicsimpact
• How to continuously improve the work of the Team
• The importance of dealing with both positive and negative feedback
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Teams and Team Working Module Subject Guide
Subject PageNumber
Introduction – the importance of teamwork 65What is a team and how does it differ from a group? 67Why use a team? 67The responsibilities of a team 68The responsibilities of the practice and dispensing teams 69Working within a team 72Team types, characteristics and roles 73The process of effective team working 77Building good working relationships 84Assessing your relationship building approach 85Learning not to overreact 87Giving and receiving feedback 88Constructive feedback 89How to approach feedback 90Barriers to effective teamwork 92Dealing with barriers 94Handling success and complacency 95Summary of team working learning 96Your action plan 97
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Activity
Introduction
Effective teamwork can make an enormous contribution to the productivity and development of any dispensary, Practice or other organisation.
Good teams obviously require effective individuals as team members but, on the whole, teams will outperform effective people working
individually. Teams can achieve more, of a better quality, more quickly and efficiently than the most competent individuals can alone.
However, effective teams take time to develop. Team leaders – GP’s, Practice Managers, Dispensers - play a pivotal role in this but essentially
teams are built on every member recognising the contribution that they have to make individually and collectively. Different people will be inclined
to contribute in different ways in helping the team successfully achieve its goals. Understanding what these different ways are is an important part
of your team building and team leading process. We will be exploring this a little later in the Workbook.
Take some time to think about some of the advantages to people and to the Practice of working in teams. Compare this to theideas over the page.
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About a Team
As the above illustrates when individuals come together as an effective team, a number of benefits can result.
√ Times for completing tasks such as dosset box compilation can be shortened.
√ Close personal relationships can develop which enhance job satisfaction and a personal sense of value and well-being. This may
result in members becoming more committed to the aims of the Practice and the dispensary and working harder to produce
better results.
√ Individuals can extend their own skills and knowledge base by observing and learning from working practices and approaches of
others more experienced.
√ Team members may be stimulated by performance challenges, and support and inspire one another to achieve their full potential.
Lead inTimes
Learning Helping Others
Challenge
SharedResponsibility
PersonalSatisfaction
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√ Opportunities may arise to be involved in a wider range of interesting and challenging jobs, which can increase job satisfaction.
√ The risk of failure is reduced through shared responsibility and decision-making. Decisions and actions are more likely to have
been considered thoroughly from many different viewpoints.
√ In some teams, creativity can be enhanced as each team member can draw on the knowledge, skills and experience of others
and use them as a sounding board for ideas.
How Does A Team Differ from a Group?
Groups are normally made up of individuals who share something in common, like an interest, but don’t necessarily work co-operatively towards a
shared aim. If you are part of an effective team you will actively pool your resources, skills and knowledge, and work together supportively,
interdependently and with a clear understanding of how each member will contribute to the whole.
Take the example of a group of Olympic sprinters who share the desire to achieve their personal best running time. They may train together but
the performance of each sprinter is not related to the success of the others. However, a soccer or other sporting team's success depends on all
members training together co-operatively to achieve a collective goal; the performance of one team
member impacts directly on the success of their team mates and the team as a whole.
The Responsibilities of a Team
In general each team in a Practice is responsible for managing its work on a daily basis. This may include:
• Having agreed goals and objectives
• Planning how targets should be accomplished
• Reviewing its performance as a team and individually in delivering those targets
• Agreeing action plans to address adverse variances
• Identifying and solving problems within the work area
Successful teams are those that can achievemore together than could be achieved bythe individuals working either alone or as agroup. The performance of one teammember impacts directly on the success oftheir team mates
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• Making operational decisions within defined levels of authority
The Key Responsibilities of the Practice and Dispensing Teams
Your existing Practice organisation may very well look something like the one opposite and will include a number of Teams, each with a special
purpose, but which need to work closely together as one team to achieve the aims of the Practice. The size of dispensing teams will obviously
differ from Practice to Practice dependent upon its individual needs. Irrespective of this, they will almost all have similar aims, which will, amongst
other things, be to do with
√ Providing the highest standard of patient service as a vital link in the core process of
delivering patient care.
√ Operating safely and ethically and within statutory and professional frameworks.
√ Providing essential financial support to the Practice, which can often be the difference to
the viability of certain Practices as businesses.
√ Helping Practices to compete in an environment that is ever changing technologically. For
example, when electronic advances make it possible for a patient to pick up a dispensed
prescription at any authorised location, the importance of building great relationships through trust, good teamwork and
communication becomes paramount.
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The exact responsibilities of the dispenser, within the Practice Team, may vary from Practice to Practice. Generally, however, the main purpose of
the Dispenser will be to provide a high standard of support to the Doctors whilst maintaining the efficient running of the Dispensary. He or she will
also ensure that all Dispensary staff practise safely and legally and that patient confidentiality is always maintained.
We will be examining some of the accountabilities for operating safely in the last module of this workbook but a brief summary would be that the
person in charge of the dispensary would need to ensure that
• The Dispensary is kept properly stocked with supplies• All medicines are prepared and dispensed accurately
Practice Organisation Chart
Partners (with lead GPusually senior partner)
(GPs/PMs/Others)
(Practice Manager)
PracticeNurses, otherclinical staff
DispensaryManager
Dispensary Team
Admin Team
IT, Finance,Reception,Secretary,
Summarisers etc
Clinical Team
issues
Community nursese.g. HV, Midwives,
DNs, MacmillanNurses
PCT
Clinical Team issues
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• All Dispensary equipment is kept in proper order, including the refrigerator• All drugs and medicines are kept safely• All the legal requirements applicable to dispensing practice and medicines are properly observed• The Dispensary is kept clean and tidy at all times• Controlled Drugs purchase and sales are recorded in the CD Register
Dispense medicines anddrugs as authorised by thedoctors in the Practice.
Collect and recordprescription charges.
Arrange for thedistribution of medicinesto patients as necessary.
Reorder supplies ofmedicines and containers.
Observe all legalrequirements relevant todispensaries including PCTregulations.
Maintain product liabilityrecords at all times.
Manage all aspects ofstock control.
Liaise with pharmaceuticalreps and obtain dispensingdoctor drug purchasing atbest possible rates anddiscounts.
The Dispenser’s Main Accountabilities in the Practice Team
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Working within a Team
Famous research undertaken by Dr Meredith Belbin looked at the idea of complementary roles in a team, with different individuals having
preferences for working within teams in different sorts of ways. Belbin’s role types, described later on in this section, were an attempt to
describe the ideal dynamics of the team and explain how people took on particular behaviours and responsibilities depending upon their own
working style preferences. We will return to the idea of team dynamics further on in this module of the Workbook.
Dr Belbin suggests
• Individuals prefer to adopt particular role in teams.
• Individuals will generally have a preference for one major role but may be able to slip
reasonably into other roles.
• Effective teams are ones where all the team roles are covered, so effective team performance
is strongly associated with ‘balanced’ teams.
• Once balanced, the diverse and complementary roles need to be managed effectively to
produce excellent results.
• Individuals’ preferences for team roles can be established using a questionnaire available from
the Belbin Organisation. (copyright Belbin)
Dr Belbin originally identified eight distinctive roles that were necessary for highly effective team performance. These original eight roles are
described later. It is unlikely that, even in a larger dispensary team, and possibly a Practice team, all eight roles will be covered. However, it is
helpful in understanding team dynamics to know about these roles because you will all be part of the wider Practice Team and some of you may
have responsibilities as a team leader.
Remember we are talking about your general preference when considering Belbin team roles. This means you may be able to carry out different
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roles – indeed at times you may have to. What Belbin’s work allows you to do is to raise your awareness of preferences in the team
environment. By playing to your preferences, and understanding those of your team colleagues, you improve your chance of giving your best and
realising when you should adjust for the sake of the team’s performance.
As mentioned, a questionnaire that can be completed in paper form or on line allows you to identify for yourself, which role(s) you tend to take on
in a team. The feedback on this questionnaire should be handled in conjunction with an adviser who is trained and accustomed to using the
Belbin profile in conjunction with the Belbin Organisation. You may be able to make an educated guess about your preferred role(s) but if you
wish to know more about your Belbin team working preference, please go the website www.smartpracticeltd.co.uk and email us. We will explain
how this can be achieved.
Team WorkerHelps the group geland resolve conflict
PlantProduces ideas andcreative thought
Co-ordinatorDirects the groupand attends toprocess
ShaperLeads, focusesand energisesthe group
CompleterFinisherAttends to detailsand structure
ImplementerOrganises, plans andgets on with things
MonitorEvaluatorAssesses thecomparativevalue of ideas
ResourceInvestigatorResearches andcontributesinformation
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“Safety Doesn’tHappen byAccident”
“Health is notSimply theAbsence ofSickness”
Health and Safety
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Health and Safety - Coverage
At the end of this section of the Workbook dispensing trainees will have a heightened knowledge and awareness ofthe following:-
• The main points of the Health and Safety at Work Act 1999 (HASAWA)
• Their legal and professional duties for health and safety in the workplace as required by HASAWA
• Other legislation relating to safe practices within their practice and their responsibilities under
• The Control of Substances Hazardous to Health Regulations 2002 (COSHH)• Manual handling• Visual Display Units• Fire
• Workplace procedures relating to controlling risks
• Safe working practices
• Potential hazards and health and safety risks
• Procedures for reporting risks, accidents and incidents
• Their role and scope of responsibility in reporting risks, accidents and incidents
• Persons in their practice responsible for health and safety matters such as fire precautions and procedures, first aid and generalsafety management.
• The need to adhere to suppliers’ and manufacturers’ instructions when using equipment, materials and products.
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• The importance of safe working practices, personal conduct, personal hygiene and use of protective clothing
• The importance of correct and safe storage and handling of hazardous materials including
• Correct storage • Checking walkways are free from obstruction• Cleaning the storage area and making it safe from
damaged stock• Safe handling of stock
• Maintaining a safe storage environment • Safe storage• Checking refrigerators work
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Health and Safety Module Subject Guide
Subject PageNumber
Introduction – the context for a health and safety culture 102The benefits of good health and safety practice 103The Health and Safety at Work Act 106The safety policy 107Specific responsibilities – yours 108Specific responsibilities – others 109Safety rules 109The Control of Substances Hazardous to Health 110Potential hazards and health and safety risks 112Safe storage and housekeeping 113Safe waste disposal 114Manual handling risks and hazards 115Safe lifting guidelines 116Working with VDUs 118Fire regulations 118Storage of oxygen cylinders 119Reducing dispensary operation risks 121Analysing the dispensing process risks 124Self audit of risk awareness in the dispensary 126Risk audits 128Reporting accidents 129Reporting serious untoward incidents 130Summary of learning 131Your Action plan 132
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Introduction
In total contrast to the attitudes that prevailed thirty or so years ago, many employers now regard the health and safety of their employees as
one of their top priorities. Management of health and safety can be a complicated task. Dealing with staffing problems, reductions in budgets,
purchaser-provider contracts and day-to-day management takes a vast amount of time and resources. It is, therefore, no surprise that health,
safety and welfare was, in the past, often left to one side - an unnecessary burden on limited time and resources. However, times really are
changing, and most right-minded employers now realise that successful health and safety management is
both cost effective and reflects the caring attitude of the employer.
This change in mindset is due in part to the huge increase in legislation in this area since
the mid 1970’s and which continues to the current day.
Thankfully, however, it is now also widely accepted that the people of an organisation
are its biggest asset. Valuable time and money is spent developing them, so it is generally accepted that employees are an
investment well worth protecting. It is hardly conducive to good working relationships if an employee is asked to accept the
risk of injury as a normal consequence of work! The smart employer will therefore seek to create a workplace and work systems that enable staff
to feel safe and secure and where management is seen to have a proactive interest in their welfare.
There are three good reasons for being concerned with safety, health and welfare at work.
• Legal, there is a need to comply with the health and safety legislation laid down by the relevant national
government.
• The moral issues of ensuring that employees, trainees or members of the public leave the care of the
organisation at the end of the day or shift in the same state of health and with the same number of limbs as
they started out with!
It is hardly conducive to goodworking relationships if anemployee is asked to acceptthe risk of injury as a normalconsequence of work!
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Activity
• Finally, there is the financial imperative. Accidents and ill health cost money. Resources should not be wasted or lost due to a poor
safety performance.
Almost all UK health and safety law is governed and qualified by the phrase "so far as is reasonably practicable". This means that the employer
must assess the relative costs and benefits of any required health and safety measure and must implement that measure unless the costs (time,
trouble and money) are grossly disproportionate to the benefits.
A book entitled Costs of Accidents at Work, produced by the Health and Safety Executive (HSE) details the results of projects in five different
organisations in which the costs of accidents were identified. One organisation found that accidents cost it the equivalent of 37% of its annualised
profits. In another, the cost was equal to 8.5% of its tender price and in a UK National Health Service hospital, 5% of its running costs. None of
these organisations suffered any fatalities, prosecutions or significant civil claims during the period of the projects. It therefore shows that an
active health and safety management system could help to reduce financial burdens on the organisation.
Think about the benefits of paying proper attention to health and safety in your own job and then compare it withthe checklist of benefits that’s listed over the page
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Conclusions
Effective health and safety measures can help to:
• Protect the health and safety of the single most important organisational asset, the employees in the Practice as well as its customers.
• Demonstrate management commitment, leading to improved morale amongst the workforce.
• Minimise the likelihood of legal action, whether instituted by an enforcement authority or as a claim for damages from an injured
employee and hold down the cost of employers' liability insurance premiums through the maintenance of a safe working environment.
• Reduce sickness absence from work and eliminate the costs associated with providing temporary cover for ill or injured employees.
Protect healthand improvemorale
Reducesicknessabsence
Enhance publicperception
Demonstratemanagementcommitment
Avoidmalpracticeclaims
You may well have identifiedother important reasons thatare special to yourDispensary or Practice andthe workbook will probablydeal with these later on
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• Enhance public perception and the reputation of the Practice as a caring employer — a proven benefit in the marketplace.
The Health and Safety at Work Act
Your employer is obliged to work in accordance with the requirements of the Health and Safety at Work etc Act 1974 (HASAWA), its subordinate
regulations and other relevant statutory provisions. Failure to comply is a criminal offence for which the corporate body – your Practice - and/or
any culpable individual can be prosecuted. The Health and Safety at Work Act (HASAWA) places general duties for health and safety on all people
at work - employers, employees and self-employed, manufacturers, suppliers, designers and importers of materials used at work, and people in
control of premises. Individuals, as well as or instead of the Practice itself, may be prosecuted for breaches of the Act.
HASAWA includes duties for the employer to provide:
• A safe place of work with a means of safe access and exit in an emergency
• Safe plant and equipment, including means for ensuring their effective maintenance
• Safe systems of work, taking into account the relationship between the worker and the task
• A safe working environment, with adequate facilities and arrangements for employee welfare
• Safe methods for handling, storage, use and transport of articles and substances
• Mechanisms to consult employees
• Enough information, instruction, training and supervision as is necessary
• A written safety policy reviewed and revised as appropriate, together with details of the organisation and arrangements for ensuring that
the policy is effective.
Developments in health and safety legislation, particularly since harmonisation with the EU in 1992, have had a fundamental impact upon the way
that every organisation is managed. They have had to revisit their customs and practices and introduce procedures to address, for example:
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• A requirement to carry out a risk assessment of every work activity (Management of Health and Safety at Work Regulations 1999)
• The need to break up periods of continuous use for workers using display screen equipment
(Health and Safety (Display Screen Equipment) Regulations 1992)
• An obligation to identify and where reasonably practicable, eliminate any hazardous manual-
handling task (Manual Handling Operations Regulations 1992)
• The protection of non-smokers from the effects of tobacco smoke under the Health Act
2006.
• Personal Protective Equipment at Work Regulations.
• Fire regulations - The Regulatory Reform (Fire Safety) Order 2005
One of the key elements of the Management of Health and Safety at Work Regulations, for example, is that employers are required to appoint
competent people to help them take health and safety measures and obtain appropriate specialist advice where necessary. Additionally all
employers must carry out a risk assessment and (if five or more people are employed), record the main findings and the arrangements for health
and safety).
The Safety Policy
The cornerstone to the health and safety culture in the Practice is the policy document, which must be in writing for those
who employ five or more persons (s.2 HASAWA).
The policy should be structured in three parts.
1 A written statement of the Practice’s commitment to health and safety signed by the senior GP or Partner and
dated.
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2 The organisation and arrangements for policy implementation. This should show who is reportable to whom and for what. It should state
how accountability is fixed, how policy implementation is monitored and the allocation of safety responsibilities.
3 Arrangements for implementing the policy. This is often in handbook form and should give practical guidelines. Examples of policies
include commitment to training, fire precautions, reporting accidents, use of display screens, personal protective equipment, safe systems
of work, safety inspections and audits, emergency procedures and manual handling.
If you have not seen the Safety Policy at your Practice you should seek it out and read it now. If you cannot find it, ask your senior GP or Practice
Manager for a copy.
Specific Responsibilities
Authority for safety measures can be delegated but responsibility cannot. Therefore, it is important to recognise that health
and safety accountability cannot be left to a Practice Manager or nominated Safety Officer, however well qualified, as in legal
terms the role is simply that of an advisor. It is the senior GP(s) or Partners at the Practice who are legally
responsible.
Your Personal Responsibilities
It is critical that, as a Dispenser, you are aware of your own personal responsibilities under health and safety legislation in
helping the Dispensary and the Practice in general to operate and deliver its services in a safe and hygienic way. Working
through this part of the Workbook in a systematic and thorough way and ensuring that you are familiar with safety
procedures and standard operating procedures (SOPs) in the dispensary will help you achieve this. Another significant
factor is your personal conduct, in terms of the conscientiousness that you apply when working day to day. For example,
your standards of personal hygiene are important. Being clean and sanitary in your daily habits by regular hand washing
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and ensuring skin infections or open wounds are covered, are of the essence when handling loose tablets, mixing powders and preparing dosset
boxes.
Considerable levels of focus and concentration are required in ensuring that drugs are dispensed in a risk free way. We will mention later on the
dangers of interruptions and lapses of concentration. In the end, it is a particular accountability of people like you to create routines and personal
checking systems to minimise risks.
Others with Specific Responsibilities
Health and safety legislation places responsibilities with employers to ensure that nominated people are trained to take on specific responsibilities,
especially for first aid, fire management and general safety accountability – carrying out assessments, investigations and audits etc.
It is important that you know who in your Practice has these responsibilities. Name them below.
Our qualified First Aid Person is
Our nominated Fire Warden is
Our Safety Officer is
Safety Rules
Usually organisations have specific rules written into their policies and procedures that define how employees should behave to fulfil their
responsibilities to work safely. The number of specific rules will generally depend on the degree of risk that prevails for a particular company or
organisation. However, HASAWA imposes a statutory duty on every employee
• To take reasonable care for the health and safety of him or herself and other people who may be affected by any lapses
• To co-operate with the employer to enable specific duties or requirements under HASAWA to be complied with.