This course explains how and why dispensing errors happen in community pharmacy, how to use near-miss and error records to improve safety, and how to build safer dispensing processes. It covers what to do when an error reaches a patient, the legal and regulatory context, and how to reflect on and remedy an error.
What you will learn
- Describe the common types of dispensing error and the stages of the dispensing process where they occur.
- Explain the human and system factors that contribute to dispensing errors, including look-alike, sound-alike medicines.
- Use a near-miss log and error reviews to identify patterns and make practical changes in the pharmacy.
- Take the correct steps when a dispensing error reaches a patient, including candour, reporting and documentation.
- Explain how the GPhC views dispensing errors and write a reflection and remediation plan supported by verifiable evidence.
Course content
- Why dispensing errors matter (2 min)
- Common types of dispensing error (2 min)
- Why errors happen: human and system factors (2 min)
- Near-miss logs and learning from errors (3 min)
- When an error reaches the patient (3 min)
- The legal and regulatory context (3 min)
- Case study, reflection and remediation plan (3 min)
- Knowledge check (10 questions, 10 min)
- Guided reflection (15 min)
Standards and guidance covered
- GPhC: Standards for pharmacy professionals (2017)
- GPhC: Standards for registered pharmacies
- Joint statement of the chief executives of the healthcare regulators, including the GPhC: Openness and honesty – the professional duty of candour (2014)
- Responsible pharmacist regulations (Medicines (Pharmacies) (Responsible Pharmacist) Regulations 2008)
- Medicines Act 1968, the Pharmacy (Preparation and Dispensing Errors – Registered Pharmacies) Order 2018 and the Pharmacy (Preparation and Dispensing Errors – Hospital and Other Pharmacy Services) Order 2022, which provide defences for inadvertent preparation and dispensing errors
- NHS Community Pharmacy Contractual Framework: clinical governance and patient safety requirements
Certificate
Courses are free to study. When you pass the knowledge check (80%) and complete your reflection, you can buy a verified certificate showing your CPD time, with a unique ID and QR code that anyone can check on our verification page.
Study free at your own pace on any device.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.