Law exam

When was the equality act brought into effect?

2010

What is the purpose of the equality act?

it legally protects people from discrimination in the workplace and in wider society
individuals should have equal treatment in empolyment, in access to private and public sector services
equality in health and social care
allowing positive action to ensure diversity in the workplace

What does the equality act make it unlawful to?

engage in prohibited conducts relating to a protected characteristic in the context of certain activities

What are the protected characteristics under the equality act?

age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation

A person has a disability if they…

have a physical or mental impairment, and the impairment has a substantial and long-term (12months+) adverse effect on their ability to carry out normal day-to-day activities
past protection applies to a person who has (previously) has a disability which lasted over 12 months as well as to a person who has one now

How are progressive conditions classed under the equality act?

can be classed as disabled, automatically meet definition with HIV, cancer or multiple sclerosis

What are the common barriers people with disabilities experience withi healthcare?

attitudinal barriers, physical barriers, communication barriers, financial barriers

What are things that are exculded from being a disability?

addiction to or dependancy on, alcohol, nictotine, or any other substance (unless medically prescribed), hayfever (unless agrevates another condition), tendancy to set fires, steal or physically or sexually abuse others, exhibitionism, voyeurism

What are the requirements for protection around gender re-assignment?

you must prepose to change your gender or have done so, it does not matter whether the individual has had treatment or surgery or if they later change their mind

What does race include?

a person’s colour, nationality, and ethenic or national origins, covers ethenic or racial groups - groups of people that share a particular protected characteristic

What counts under the protected characteristic religion or belief?

any religion and a lack of religion - any religion of sufficent seriousness which has a clear structure and belief system, denominations or sects within a religion, philosophical beliefs and a lack of them

What is prohibited conduct under the equality act?

direct discrimination, combined discrimination, indirect discrimination, failure to make resonable adjustments, harassment, victimisation due to discrimination by association or complaining about discrimination

Who does the equality act protect people from?

employers, buisnesses and organisations that provide goods or services, health and care providers, someone you rent or buy a property from, education providers, transport services, public bodies

What is the socioeconomic duty of public sector bodies?

adopt transparent and effective measures to address inequalities rising from differences in occupation, education, place of residence, or social class

What is the equality duty of public sector bodies?

eliminate discrimination, advance equality of opportunity, foster good relations between different people when carrying out their activities

How can you avoid discrimination?

educate yourself and others
encorage individuals to respect each other’s differences
challange and/or respond quickly to any evidence or complaints of inappropriate behavoir
develop a workplace environment and/or policy that prohibits discrimination
undergo training and keep it up to date
understand workforce/ institutional policy on discrimination and follow agreed ways of working
delivery of person centred care - treat all individuals as unique

When is there a duty to make resonable adjustments?

if the individual is placed at a substantial disadvantage because of their disability compared with non-disabled people or people who don’t share their disability

What do pharmacy services need to consider that they might need to provide resonable adjustments for?

premises, dispensing process and supply of medicines, experience of pharmacy services, help required for the indivdual to use their medicines correctly, they should never be charged for these adjustments

What does the Accessible Information Standard state?

that all organisations that provide NHS care and/or publicly-funded adult social care must make health and social care information accessable

What year did the accessable information standard come into effect?

2016

What should pharmacies do to follow the accessible information standard?

a specific consistant approch to identifing, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a diability impairment or sensory loss

What are the 5 basic steps to ensure that you are providing information in an accessable way? Explain each one

ask - identify if an indivdual has any communication/information needs relating to disability or sensory loss and what they are
record - record these needs clearly, unambigously and in a standarised way
alert - ensure that recorded needs are highly visable when patient records are accessed and prompt for action
share - include this information as part of existing data sharing processes
act - take steps to ensure that individuals receive information which they can access and understand, and recieve communication support if they need it

What does if the adjustment is resonable depend on?

disability, praticality, would it overcome the disadvantage, size of organisation, money and resources availible, cost, what changes have already been made

What should individuals know about their medications?

name, why?, how much?, when to take?, positive and negative effects, Where to store?, When the next supply is due?

What is the purpose of data protection?

• ensures people can trust you to use their data fairly and responsibly

• recognises a person’s right to have control over their own information

• recognises that data protection is needed for innovation

If you collect information about individuals for anything other than personal, family or household reasons what laws does it need to comply with?

Data protection act 2018, General data protection regulation (GDPR) 2018 and Human rights act 1998 (HRA)

What does ISO stand for?

information commissioner’s office

What do the ISO do?

regulate data protection in the UK

What does the Data Protection Act do?

it’s the data protect framework in the UK (with GDPR)

What is UK GDPR?

rights and obligations for most processing of personal data in the UK

What is personal data defined as?

• information that relates to an identified or identifiable individual

• information about a living individual or the ‘data subject’

• doesn’t need to be private information

• sensitive data (e.g. health data)

What is a data controller defined as?

an organisation or individual who decides how and why to collect and use the data

What is data processing defined as?

collecting, recording, storing, using, analysing, combining, disclosing, deleting, etc.

What are the data protection principles?

• used fairly, lawfully and transparently

• used for specified, explicit purposes

• used so that it is adequate, relevant and only what is needed

• accurate and if needed up to date

• kept no longer than needed

• appropriate security, with protection against unlawful/unauthorised processing, access, loss, destruction or damage

What information has additional legal protection?

sensitive information (e.g. race, ethnicity, religion, sexual orientation, sexual activity, etc.)

At least one of the following must apply for processing of personal data to go ahead……

• consent from the individual for a specific purpose

• legal obligation (to comply with the law)

• due to a contract or steps before a contract between you and the individual

• vital interests - to protect someone’s life

• public task

• legitimate interests

What must you do if you are using a lawful basis for processing data?

inform the individual who has the right to protest how this data is processed

What are the GDPR standards for valid consent?

• freely given

• obvious and require positive

• action to opt in

• must cover controller’s name, purpose and type of processing

• confirmed in words

• no time limit

• rules for opportunities to withdraw

• clear record keeping

When should you use consent to legally process data?

only if you can offer them a real choice

What does health data refer to?

current, past, or future physical or mental health

What are the lawful basis for processing patient health data?

• provision of direct care and related administrative purposes

• commissioning and planning purposes

• planning and running the NHS

• for research (must have legal basis and sometimes consent)

• safeguarding or legal duties

• subject access request

What are the standards for vald consent by GDPR?

freely given
obvious and require positive action to opt in
specifically covers the controller’s name, the purposes of processing and the types of processing activity
expressly confirmed in words rather than by any other positive action
no set time limit
rules for oppotunities to withdraw
clear record keeping
only if can offer a real choice

What is health data?

personal data relating to current, past or future physical or mental health

What is the lawful basis for using patient’s health data?

provision of direct care and releated administrative perposes
commissioning and planning purposes
for planning and running the NHS
for research (legal basis and may need concent)
safegarding or other legal duties
subject access request

What are the individual’s rights under GDPR?

to be informed, of access, to rectification, erasure, restrict processing, data portability, to object, rights in relation to automated decision making

What is a processor?

someone responsible for processing personal data on behalf of a controller, maintain records, take liability for breeches

What is a controller?

someone who determines the purposes and means of processing personal data, ensures contracts with processors comply with GDPR

What do data protection officers do?

iassist monioring internal compliance, inform and advise on your data protection obligations, provide advice regarding data protection impact assements (DPIAs), act as a contact point for data subjects and the information commissioner’s office (ICO)

What pharmacy environments require a data protection officer and why?

community pharmacies - provide NHS services under national pharmacy contract so are a public authority, NHS hospitals are a public sector body, GP practices

What does the GDPR law say around data protection officers?

if you are a public authority or body, or if you carry out certain types of processing activities the you have a duty to appoint a data protection officer

What are the requirements for the data protection officer?

inderpendent, have qualifications and experience, not the data controller due to a conflict of interest, exisiting employee or externally appointed, can be shared, all that are processing personal data know who it is

When are you processing data as a pharmacist?

taking prescriptions, use info on patient’s record to dispense medication, discussing patient with other healthcare proffessional, when you undertake an audit of medication reveiws, veiwing the summery care record of a patient

What is a personal data breach?

a breach of security leading to the accidental or unlawful destruction, loss, alteration, unauthorised disclosure of, or access to, personal data

What happens if there is a deliberate breach?

pharmacists, technitians and organisations have been prosocuted by the ICO, the GPhC may pursue fitness to practise cases

What are the conquenses of inadvertant breaches of personal data?

particulary serious as the data is sensitive, patient confidentiality and data protection can often be a problem

What was the change to the cumberledge report in 1992?

certain nurses are allowed to prescribe a limited range of products

When were PGDs indroduced and by which report?

1993 Crown report

What is a PGD?

a written direction that allows the supply and/or aministration of a specific medicine or medicines, by named authorised health proffessionals, to a well-defined group of paitents requiring treatment for a specific condition

When was the second crown report reccomendation and what did it say?

1999 extended prescribing rights to other HCPs

When was the Health and social care act published?

2001

In regards to prescribing, what happened in 2006?

there was an amendment to NHS Regulations so that suitibly trained nurses and pharmacists could prescribe any licenced medication for any medical condition within their own competence as ‘Non-Medical Prescribers’

What are non-medical prescribers?

pharmacists, nurses, midwives and other allied healthcare proffessionals who have completed an accredited prescribing course and registered their qualification with their regulatory body, are able to prescribe

What is a supplementry prescriber?

a practitioner who prescribes whithin an agreed patient specific written clinical management plan, agreed in partnership with a doctor or dentist

What does CMP stand for?

clinical management plan

What is the prossess of supplementary prescribers?

1. Diagnosis of clinical condition by a medical practioner

2. Agreement by service user to be managed by a prescribing partnership

3. creation of a clinical management plan (CMP) by medical practitioner, supplimetry prescriber and service user

4. Management of the service user within the terms if the CMP

What is an inderpendent prescriber?

a practitioner who is responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and can make prescribing decisions to manage the clinical condition of the patient

What is the prescribing competancy framework?

produced and maintained by the RPS, a prescribing framework for all prescribers, describes knowledge, skills, characteristics and behavoirs for safe and effective prescribing role

What are the 2 domains of the prescribing competency framework?

the consultation and prescribing governance

What are the different prescriber types?

Doctors, dentists and vets can prescribe at the point of registration (now pharmacists too)
indepedent and supplement prescribers require extra training

What are the 12 steps of the RPS Guidence on Safely Prescribing?

personal development, reflect, keep up to date (CPD, revalidation), professional judgement, speak up, professional indemnity, improving practice, audit, errors/near misses, remote prescribing, prescribing legally, document, support others

What does the law say about scope of practice for prescribing?

prescribes within own scope of practice, and recognises the limits of own knowledge and skill
must have required training, knowledge, skills and experience and indemnity cover for prescibing role

How do you expand or change your scope of practice? What can you change it to?

reflect, plan, act, evaluate
prescribe greater range of medicines, need to better support pacient care, deliver new service, change of job or setting

What do you need to take into account when using professional judgement in prescribing?

person centred care, safety, duty of care, legal, regulatory and proffessional obligations, contractual and company proceedures

What is remote prescribing?

where the consultation is online or on the phone

What are the questions you need to take into account when prescribing remotely?

Can you recognise when a person may need a physical or in-person assesment?
Do you know where to signpost them to?
Is there a process for when you can refer a person to a medical prescriber while working remotely?
How can you gain concent?
should feel both competent and safe to prescribe

When are remote consultations/prescribing not appropriate?

lack of patient access or ability to use technology, impared capacity to participate, red flags suggest a need for urgent medical attention, insufficent access to required information such as records or resources

What are the legal and good practice considerations around prescribing and dispensing the same medicine?

wherever possible should be seporate functions, peformed by seporate HCPs - this improves safety as it reduces likelihood of errors, however there is no legal restriction on this

If you are prescribing and dispensing a medicine to a patient what else do you need to do/follow?

conduct a risk assement, follow a procedure, best interest of the patient, take a mental break between activities, maintain an audit tratin and rationale for decision, report errors and near misses to learn and change practice

Can you prescribe for yourself, freinds and family?

Leagally yes, but it is poor practice, if exceptional situations occur: objectivity, documentation and monitoring, external input

Can pharmacist IPs prescribe CDs? What CDs?

yes, schedule 2-5 but not cocaine, diamorphine or dipipanone for treating addiction

Can pharmacist IPs prescribe unlicensed/off-label medicines?

yes

Can pharmacist IPs authorise an emergancy supply for items which can be prescibed?

yes, but no schedule 1,2,3 CDs aside from phenobarbital for epilepsy

What is the main legislation for veterinary medicines called?

Veterinary Medicines Regulations 2013

What is the legal definition of veterinary medicines?

all products or substances that give the impression of treating/preventing disease or restore, corrects, modifies physiological functions by exerting a pharmacological, immunological or metabolic action in animals other than humans

What is the organisation in charge of veterinary medicines?

the veterinary medicines directorate (part of the department for environment, food and rural affairs)

What are the key role and responsibilities of the veterinary medicines directorate?

• pharmacovigilance, monitor and act upon any adverse effects

• testing veterinary medicines in animals and animal products

• licencing veterinary medicines (MAs)

• assess and authorise companies to sell veterinary medicines

• control how veterinary medicines are made and distributed

• inspects premises involved in the supply chain

• advises government ministers

What is a POM-V medicine?

prescription only medicines that can only be prescribed by a veterinary surgeon and supplied by a veterinary surgeon or a pharmacist with the prescription, a clinical assessment is required (the vet must see the animal recently before the prescription)(must be under the vet’s care)(the vet must keep records)

What is a POM-VPS medicine?

prescription only medicines that are prescribed or supplied by a veterinary surgeon, pharmacist or a suitably qualified person on an oral or written prescription. The written prescription is only required if the prescriber is not the supplier

What is a NFA-VPS?

medicines for non-food animals that is supplied by a veterinary surgeon, pharmacist or suitably qualified person, no written prescription is required

What is a AVM-GSL?

an authorised veterinary medicine available on general sale

What is a suitably qualified person?

a person who is trained and registered (with the VMD) to sell a limited range of veterinary medicines

What is a medicine that is exempt?(SAES)

an unlicenced veterinary medicine that does not require a MA due to exemptions under the VMR - Exemptions for small pet animals, there are no restrictions on the retail supply of these medicines. Topical and oral only. Must follow manufacturing requirements. Pharmacovigilance still applies.

What are unauthorised veterinary medicines?

an unlicenced medicine without a MA and is not exempt through SAES, can only be prescribed by a veterinary surgeon under cascade, includes any human medicines used for animals

What is required on any veterinary prescription?

• prescriber name, address, telephone number, qualification and signature

• owner’s name and address

• identification, species and address of animal (if different from owner)

• date

• name, quantity, dose and administration instructions of the required medicine

• any warnings or withdrawal period (if needed)

• if needed a statement saying that the medicine has been prescribed under veterinary cascade

• if repeatable the number of times it can be repeated

What is the withdrawal period with animals?

the time that must elapse between when an animal receives a medicine and when the animal can be used for food

What are the additional prescription requirements if the medicine is a Sch 2 or 3 CD for animals?

• the registration number (RCVS) of the prescriber

• a declaration that ‘the item has been prescribed for an animal or herd under the care of the veterinarian

How long are veterinary prescription valid for?

• 6 months or shorter if indicated by the prescriber

• Sch 2,3 and 4 CDs are valid for 28 days

How long should veterinary prescriptions for controlled drugs be retained for?

5 years

What is the required form for a veterinary prescription?

no required form

For good practice how much supply of CD should you provide?

maximum 30 days unless long term ongoing medication needed or justifiable reasons