Pharmacist shortage adds to risk of medication mistakes

Auckland City Hospital patients are at a higher level of risk of medication errors than usual because of an unprecedented shortage of pharmacists.

The scarcity of pharmacists is the latest in an unending series of health-worker shortages to afflict parts of Auckland or the whole country, some of the worst being among junior doctors, pathologists and anaesthetic technicians.

Auckland City Hospital budgets to employ the equivalent of 34 full-time pharmacists, but has only 22, leading to many wards having to do without one.

The basic role of pharmacists is to prepare medicines in the right doses, including cancer chemotherapy, to be administered to patients by nurses.

But to minimise medication errors, the hospital's pharmacists normally also work in 50 wards or other clinical areas such as mental health units.

"Unprecedented staff shortages in clinical pharmacy will result in services to 10 clinical areas being withdrawn in September," say Auckland District Health Board papers for October.

In his monthly report to the board, chief medical officer Dr David Sage says: " ... in the wards now functioning with a lower pharmacist presence there is acceptance of a higher level of risk.

"The created levels of vigilance requested of all the clinical staff in these wards pending replacement will have little impact because the role of the pharmacist is in part to pick up errors not detected by other clinical staff."

Chief pharmacist Sarah Fitt yesterday agreed. "Doctors are responsible for prescribing, nurses are responsible for administration and we put in an extra safety check.

"We've got so short we have had to put our focus back on our basic dispensing service."

Ms Fitt hoped to be down to four or five vacancies - from the present 12 - by the end of the year with the appointment of newly registered pharmacists and experienced staff.

Pharmacists would then be posted back to the 10 hospital wards - none had been withdrawn from the mental health units - at present without them.

"There is a national and international shortage of hospital pharmacists. Recruitment is always an issue for us," she said.

But it had become harder this year because of the ending of a reciprocal agreement between New Zealand and Britain covering pharmacist registration.

The agreement ended because of Britain's commitments to the European Union.

Before the changes coming into force on February 1, Ms Fitt said, it was relatively easy for pharmacists from either country to register in the other. Only a period of supervision and an interview were required.

But now New Zealanders had to have a lengthy period of extra study to work in Britain and Britons coming to New Zealand had to pass an exam.

"In the past, we've picked up people who were travelling. They work for six to nine months. People aren't going to bother doing an exam," said Ms Fitt, who came from Britain intending to stay one year and has been here for nearly nine.

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