Accountability & Responsibility in Prescribing

What is the difference between accountability and responsibility in pharmacy practice?

Accountability is being answerable for decisions and outcomes, while responsibility is the duty to act within one’s role and competence.

Why is professional and legal credibility important for pharmacists?

It maintains public trust in pharmacy and healthcare, and ensures safe, ethical practice.

Name a professional framework used to guide pharmacists in the UK.

GPhC Standards for Pharmacy Professionals.

Which other healthcare professions have similar frameworks to pharmacy?

NMC (nursing) and GMC (medical) frameworks.

Name one key UK law regulating medicines.

Medicines Act 1968.

Which regulations govern controlled drugs?

Misuse of Drugs Regulations 2001

Why is clinical governance important in pharmacy practice?

It ensures safe, effective, and accountable care.

What should a pharmacist do if a patient’s needs fall outside their competence?

Refer to an appropriate professional.

Give an example of shared responsibility in a multidisciplinary team (MDT).

Collaborating to avoid duplication of prescribing or conflicting decisions.

Can a pharmacist delegate legal accountability for prescriptions?

No, the pharmacist whose name is on the prescription remains legally accountable.

What should a pharmacist document in their records to demonstrate accountability?

Rationale for decisions, clinical judgment, and actions taken.

Name three factors considered in clinical judgment.

Co-morbidities, allergies, and polypharmacy.

What is the main goal when balancing risk vs. benefit in prescribing?

Maximising patient benefit while minimising harm.

Name the four ethical principles outlined by Beauchamp and Childress.

• Beneficence

• Non-maleficence

• Autonomy

• Justice (confidentiality is part of justice).

What does the duty of candour require of healthcare professionals?

Being open and honest about errors to patients and colleagues

What four elements must be proven to succeed in a tort of negligence?

1) Duty of care,

2) Breach of duty,

3) Demonstrable loss,

4) Direct link (causation).

Which case defines the standard of care expected of a reasonable health professional?

Bolam test (and Bolitho for logical reasoning and Montgomery for informed consent).

Who is accountable for a prescribing error?

While most errors have systemic causes, the individual who made the prescribing decision is accountable.

What is the difference between defensive and safe prescribing?

Defensive prescribing is fear-driven, prioritising avoidance of blame, while safe prescribing prioritises patient-centred safety.