NHS Patient Safety – Medication

How can Pharmaceutical Companies contribute to improving NHS Patient Safety?

They can demonstrate ‘added value’ , for example, by either offering products which contribute directly to making the administration of medicines safer by helping to reduce:-

• Making the drug up to the wrong strength
• Using the wrong diluent
• Microbial or other forms of contamination
• Labelling errors
• Administration by the incorrect route by clearer design/packaging of the product

The products which are commonly offered as part of a compounding service include:-

• Cytotoxics
• Antibiotics
• Inotropes
• Potassium solutions
• TPN
• Unlicensed medicines

In addition, the provision of non-promotional training/educational services to healthcare professionals in the form of Continuing Professional Development events and nurse advisor teams helps to educate NHS staff on how to administer medicines more

• Confidently
• Accurately
• Competently

The Department of Health (DH) has issued the following list of ‘Never Events’ for 2012-13. The list is circulated to a wide range of NHS managers, clinicians and healthcare professional allied to medicine.

The document authors are the DH’s Patient Safety and Investigations unit. The purpose of the document is to highlight certain events which are deemed to be very serious risks to the standard of care to patients, but most importantly avoidable.

The document forms part of the wider DH’s Patient Safety Agenda policy and should be read in conjunction with the NHS Standards Contract for organisations providing services to the NHS

1. Wrong site surgery
2. Wrong implant/prosthesis
3. Retained foreign object post-operation
4. Wrongly prepared high-risk injectable medication
5. Maladministration of potassium-containing solutions
6. Wrong route administration of chemotherapy
7. Wrong route administration of oral/enteral treatment
8. Intravenous administration of epidural medication
9. Maladministration of Insulin
10. Overdose of midazolam during conscious sedation
11. Opioid overdose of an opioid-naïve patient
12. Inappropriate administration of daily oral methotrexate
13. Suicide using non-collapsible rails
14. Escape of a transferred prisoner
15. Falls from unrestricted windows
16. Entrapment in bedrails
17. Transfusion of ABO-incompatible blood components
18. Transplantation of ABO incompatible organs as a result of error
19. Misplaced naso- or oro-gastric tubes
20. Wrong gas administered
21. Failure to monitor and respond to oxygen saturation
22. Air embolism
23. Misidentification of patients
24. Severe scalding of patients
25. Maternal death due to post partum haemorrhage after elective Caesarean  section

Source: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132352.pdf

You can read the whole document if you wish, but the indicators within the specific areas where the Pharmaceutical Industry has opportunities to work in conjunction with the NHS includes:-

1. Wrongly prepared high-risk injectable medication

• Death or severe harm as a result of a wrongly prepared high-risk injectable       medication.
• High-risk injectable medicines are identified using the NPSA’s risk assessment tool1. A list of high-risk medicines has been prepared by the NHS Aseptic Pharmacy Services Group using this tool2. Organisations should have their own list of high-risk medications for the purposes of the “never event” policy, which may vary from the NHS Aseptic Pharmacy Services Group list, depending on local circumstances.
• A high risk injectable medicine is considered wrongly prepared if it was not; o prepared in accordance with the manufacturer’s Specification of Product Characteristics;

1 NPSA High Risk Medication Risk Assessment Tool, 2007, available at

http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60097&type=full&servicet ype=Attachment

2 Pharmaceutical Aseptic Services Group. Example risk assessment of injectable medicines. 2007. Available at http://www.civas.co.uk/

• This event excludes any incidents that are covered by other “never events”.
• Where death or severe harm cannot be attributed to incorrect preparation, treat as a Serious Untoward Incident.

5. Maladministration of potassium-containing solutions

• Death or severe harm as a result of maladministration of a potassium-containing solution.

Maladministration refers to;

• selection of strong potassium solution instead of intended other medication,
• wrong route administration, for example a solution intended for central venous catheter administration given peripherally,
• infusion at a rate greater than intended.

Setting: All healthcare settings.

Guidance: – Patient safety alert – Potassium chloride concentrate solutions, 2002 (updated 2003), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59882

6. Wrong route administration of chemotherapy

Intravenous or other chemotherapy (for example, vincristine) that is correctly prescribed but administered via the wrong route (usually into the intrathecal space).

 

Setting: All healthcare premises.

Guidance: – HSC2008/001: Updated national guidance on the safe administration of intrathecal chemotherapy, available at http://www.dh.gov.uk/en/publicationsandstatistics/lettersandcirculars/healthservicecirculars/dh_ 086870 – Rapid Response Report NPSA/2008/RRR004 using vinca alkaloid minibags (adult/adolescent units), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59890

7. Wrong route administration of oral/enteral treatment

Death or severe harm as a result of oral/enteral medication, feed or flush administered by any parenteral route.

Setting: All healthcare settings.

Guidance: – Patient Safety Alert NPSA/2007/19 – Promoting safer measurement and administration of liquid medicines via oral and other enteral routes, 2007, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59808

8. Death or severe harm as a result of intravenous administration of epidural medication.

• A broader “never event” covering intravenous administration of intrathecal medication or The “never events” list 2012/13 9 intrathecal administration of intravenous medication is intended once the deadlines for Patient Safety Alert 004A and B actions have passed.

 Setting: All healthcare premises.

Guidance: – Patient Safety Alert NPSA/2007/21, Safer practice with epidural injections and infusions, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59807 – Safer spinal (intrathecal), epidural and regional devices – Parts A and B, available at http://www.nrls.npsa.nhs.uk/resources/?EntryId45=65259

9. Maladministration of Insulin

Death or severe harm as a result of maladministration of insulin by a health professional. Maladministration in this instance refers to when a health professional

• uses any abbreviation for the words ‘unit’ or ‘units’ when prescribing insulin in writing,
• issues an unclear or misinterpreted verbal instruction to a colleague,
• fails to use a specific insulin administration device e.g. an insulin syringe or insulin pen to draw up or administer insulin, or
• fails to give insulin when correctly prescribed.

Setting: All healthcare settings.

Guidance: – Rapid response report – Safer administration of insulin, 2010, available at http://www.nrls.npsa.nhs.uk/alerts/?entryid45=74287 – NHS Diabetes – Safe use of insulin, 2010, available at http://www.diabetes.nhs.uk/safe_use_of_insulin/ – NHSIII Toolkit – Think Glucose, 2008, available at http://www.institute.nhs.uk/thinkglucose – NHS Diabetes guidance – The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus, 2010, available at http://www.diabetes.nhs.uk/document.php?o=1037

19. Misplaced naso- or oro-gastric tubes

Death or severe harm as a result of a naso- or oro-gastric tube being misplaced in the respiratory tract.

Setting: All healthcare premises.

Guidance: – Patient safety alert – Reducing harm caused by misplaced nasogastric feeding tubes, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59794 – Patient safety alert – Reducing harm caused by misplaced naso and orogastric feeding tubes in babies under the care of neonatal units, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59798&q=0%c2%acnasogastric%c2%ac

Please visit the20:20Selection website if you have found this article helpful, as we regularly update the articles in our Factsheet section

http://www.2020selection.co.uk

Pharmaceutical Sales – A spark of interest

Having embarked on a career as a medical representative in 1987, I still reflect on the route that led me to the pharmaceutical industry.  Being a Pharmaceutical Sales Representative doesn’t often appear in the list of careers that we aspire to as teenagers hence it is invariably something people come across coincidently.  For me I spent five years in a hospital Biochemistry Dept completing post graduate studies and developing a strong clinical understanding of various diseases and illnesses.  It was here I met Sales Representatives selling laboratory diagnostics and equipment which sparked an interest in sales (I have to admit to being initially impressed by the suit, car and perceived flexibility of their job).  In fact what did appeal to me about a sales role was the inherent challenges working towards targets and ultimately being rewarded (bonus) and recognised for exceeding goals (working in the NHS could not fulfil that need) as well as selling products which genuinely make a difference to people’s lives.

Hence I started buying the New Scientist and Daily Telegraph; there was no internet job searching in those days! Quite quickly I secured two interviews for Laboratory Territory Manager positions before seeing an advertisement for Trainee Medical Representatives with a major pharmaceutical company.

Have to confess at that stage that pharmaceuticals was a bit of a mystery to me, but my Dad said that company was great (blue-chip), and there was a number to call to apply.  Two interviews later, including being flown to head office, I was offered a GP/Hospital Representative position.

Looking back I do wonder how I got that job as these days we expect entry level candidates to know so much more about the day to day practicalities of the role, the NHS and how the business works.  Clearly the company were looking for the basic ingredients which they could then train, develop and mould to reflect their values and culture in the eyes of their customers;  GP, Nurses, Pharmacists, Consultants, Registrars, SHO etc.

Over twenty years later in a different NHS landscape I still believe this to be true so what are some of those basics;

Personal Qualities – An inner drive, self-starter, the ability to work on your own initiative, enthusiasm, can-do attitude, tenacity, the ability to problem solve, good interpersonal skills, the willingness as well as aptitude to learn.

Clinical Foundation – This means an interest in medicine, the ability to learn and apply technical information.  You will need to communicate this knowledge to customers of all levels.  ‘A’ level standard Biology should help with ABPI. 

Business & Selling Skills – Understand you are there to increase sales; it is a sales job & not a promotional or educational position.  Have a consultative selling style, i.e. probe to understand the customer needs and agenda before offering solutions. Key Account Management & Networking Skills. Understanding local NHS politics, targets, agenda and how these may impact on your business.

Clearly a lot of clinical and business skills can be taught as long as you have the right positive attitude. In summary I would describe the role of a Medical Sales Representative, whether that be GP, GP/Hospital, Hospital or Generics as the opportunity to run your own local business.

I have enjoyed a varied, challenging and satisfying career in the pharmaceutical industry. I also know others, who embarked on their career at the same time, who have had similar experiences and taken their careers in to different functions in the industry including: Marketing, Senior Sales Management, Training, Consultancy as well as others who are now Senior Representatives such as Hospital Specialist Representative or Healthcare Development Manager.

If this sparks an interest in you fantastic!  To discuss your background and transferable skills then contact 20:20 Selection Ltd on 0845 026 2020 or visit www.2020selection.co.uk . We have current opportunities Nationwide with hot-spots in London, Kent, Sussex, Essex, Somerset, Wiltshire, East Anglia.

Key Account Manager Roles – Catching a KAM

Many articles have been written about the best way to engage with our customers in the NHS. How best to partner with this new breed, made up of payers, commissioners, and medicines management gurus. How best to tap into their agenda. In fact, many careers have been built on telling us just how to sell to our customers, and an awful lot of consultancy fees have been paid to experts so that we can all be scared to death about this ‘new’ customer group who we are told work hidden away, been firmly shut doors in an increasingly complex and confusing NHS maze.

In my simple world view, yes, of course we do need to speak the same language as our customers, but we also need to ensure that we are getting the balance right, to ensure that our customer partnerships are mutually beneficial. We need to be truly customer focused, but we also need to achieve the win:win equilibrium, to avoid promising the world in value added services for very little commercial return.

Over the last few years, Key Account Management has been the new pharma industry term that seems to be bandied about on a daily basis. It is used often and widely and it seems to mean different things to different people in different companies. Every hiring manager seems to be looking for the elusive KAM. Does it mean a hospital representative? Does it mean an NHS Liaison Manager? Is it a bit of both? Or is it just a very good salesperson with the right attitude, the right skills and the common sense to convince key influential customers to sit round a table, to weigh up the pros and cons, and to agree on decisions that will help them to achieve their desired outcomes, but that will also grow product sales for their company?

In many ways, Key Account Management is a philosophy; a way of thinking, rather than some magical process. Account plans and systems can of course help to keep business on track, but they cannot be the golden ticket on their own. People still, and always will, buy from people.  Outstanding KAM’s need to be outstandingly talented sales people. In the ‘good old’ days, when sales people were autonomous, and they had full accountability for their results, the successful ones managed their own business and they managed it well. Naturally, they identified and involved all key stakeholders, naturally they engaged with clinicians, and non clinicians alike, and naturally they engaged the people who ultimately held the purse strings. They were unblocking the clinical and funding barriers that KAM’s and Market Access Manager’s do today, whilst always remembering to sell.

This breed are driven, competitive, innovative, competitive, hardworking, flexible responders to change and above all, as superb net workers and communicators, they can be relied upon to consistently achieve results.

At 20:20 Selection Limited, we know that recruitment agencies are mainly fishing from the same pond. The skill we use to catch the KAM’s is to recognise the specific species, and to know which bait to use.

Interview Guidance

Interview Guidance

PRIOR TO the Interview

Research

• Look committed and find out as much as possible about the company.

 

• Visit their web site for more information on the company.

 

• Find out who will your competitors be and as much as possible about the market/customers you will be selling to 

 

Job Description

• Make sure you are fully aware what the role is you are being interviewed for.  Your consultant at 20:20 Selection Ltd will have fully briefed you on this. 

 

• Be confident that you are technically qualified to do the job.  We would not have spoken to you about the role if we didn’t think your profile matched the client’s criteria!

 

• Have examples from your previous roles to demonstrate your ability to do this job and evidence in your brag file to back this up

 

FOR THE INTERVIEW

Personal Presentation

• Look your smartest and show your most professional side during the interview. A company is more likely to employ someone who is well presented and who will therefore best represent their company to customers. 

 

Punctuality

• Arrive to start the interview on time (be early if possible)

 

• Obtain clear directions for the location of the interview and plan your journey, allowing plenty of time to arrive.

 

INTERVIEW DO’S

• Introduce yourself courteously (first impressions last!)

 

• Express yourself clearly.

 

• Show tact, manners, courtesy, and maturity at every opportunity.

 

• Be confident and maintain poise. The ability to handle your nerves during the interview will come across as confidence in your ability to handle the job.

 

• Be prepared to show how your experience would benefit the company.

 

• Ask questions concerning the company or products and the position for which you are being interviewed for. An interviewer will be impressed by an eager and inquisitive mind. You will also be able to demonstrate that you can contribute to the company or industry if you show an interest in its products and/or services.

 

• Take time to think and construct your answers to questions to avoid rushing into a vague and senseless reply.
• Demonstrate that you are sufficiently motivated to get the job done well and that you will fit in with the company’s organisational structure and the team in which you will work.

 

• Show willingness to start at the bottom and work up.

 

• Anticipate questions you’re likely to be asked and have answers prepared in advance. Uncertainty and disorganisation show the interviewer that you are unprepared and unclear what your goals are.

 

• Be assertive without being aggressive (ensure you close – remember you are a sales person & ‘you’ are your product)

 

• Thank the interviewer for their time

 

Interview Don’ts

• Be late for the interview. Tardiness is a sign of irresponsibility or disorganisation and the employer could take it as what to expect in the future.

 

• Arrive unprepared for the interview.

 

• Say unfavourable things about previous employers.

 

• Make excuses for failings.

 

• Give vague responses to questions.

 

• Show lack of career planning – no goals or purpose could convey the impression you’re merely shopping around or only want the job for a short time.

 

• Show too much concern about rapid advancement.

 

• Overemphasise money. Your interviewing goal is to sell yourself to the interviewer and to get an offer of employment. Salary discussion is secondary.

 

• Show any reservations you may have about the role/company. You can always turn down second interviews and job offers after you have had time to appraise your concerns in the cold light of day.

 

• Express strong prejudices or any personal intolerance.

 

• Leave your mobile phone on during the interview.

 

These are general tips that can be applied to any interview situation.  Part of the service we offer at 20:20 Selection Ltd is to help you prepare for specific client interviews.  We have key account managers specifically working with clients & members of the team who come from a pharmaceutical sales management background so you will get personalised expert advice relating to your interview!  To find out more about 20:20 Selection Ltd visit www.2020selection.co.uk

Nurse Advisor and similar roles within the Pharmaceutical Industry

Top 10 Interview Questions

Too many job seekers stumble through interviews as if the questions are coming out of left field. But many interview questions are to be expected. Study this list and plan your answers ahead of time so you’ll be ready to deliver them with confidence.

What Are Your Weaknesses?
This is the most dreaded question of all. Handle it by minimising your weakness and emphasising your strengths. Stay away from personal qualities and concentrate on professional traits: “I am always working on improving my communication skills to be a more effective presenter. I recently joined Toastmasters, which I find very helpful.”

Why Should We Hire You?
Summarise your experiences: “With five years’ experience working in the financial industry and my proven record of saving the company money, I could make a big difference in your company. I’m confident I would be a great addition to your team.”

Why Do You Want to Work Here?
The interviewer is listening for an answer that indicates you’ve given this some thought and are not sending out CVs just because there is an opening. For example, “I’ve selected key companies whose mission statements are in line with my values, where I know I could be excited about what the company does, and this company is very high on my list of desirable choices.”

What Are Your Goals?
Sometimes it’s best to talk about short-term and intermediate goals rather than locking yourself into the distant future. For example, “My immediate goal is to get a job in a growth-oriented company. My long-term goal will depend on where the company goes. I hope to eventually grow into a position of responsibility.”

Why Did You Leave (Or Why Are You Leaving) Your Job?
If you’re unemployed, state your reason for leaving in a positive context: “I managed to survive two rounds of corporate downsizing, but the third round was a 20 percent reduction in the workforce, which included me.”

If you are employed, focus on what you want in your next job: “After two years, I made the decision to look for a company that is team-focused, where I can add my experience.”

When Were You Most Satisfied in Your Job?
The interviewer wants to know what motivates you. If you can relate an example of a job or project when you were excited, the interviewer will get an idea of your preferences. “I was very satisfied in my last job, because I worked directly with the customers and their problems; that is an important part of the job for me.”

What Can You Do for Us That Other Candidates Can’t?
What makes you unique? This will take an assessment of your experiences, skills and traits. Summarise concisely: “I have a unique combination of strong technical skills, and the ability to build strong customer relationships. This allows me to use my knowledge and break down information to be more user-friendly.”

What Are Three Positive Things Your Last Boss Would Say About You?
It’s time to pull out your old performance appraisals and boss’s quotes. This is a great way to brag about yourself through someone else’s words: “My boss has told me that I am the best designer he has ever had. He knows he can rely on me, and he likes my sense of humour.”

What Salary Are You Seeking?
It is to your advantage if the employer tells you the range first. Prepare by knowing the going rate in your area, and your bottom line or walk-away point. One possible answer would be: “I am sure when the time comes, we can agree on a reasonable amount. In what range do you typically pay someone with my background?”

If You Were an Animal, Which One Would You Want to Be?
Interviewers use this type of psychological question to see if you can think quickly. If you answer “a bunny,” you will make a soft, passive impression. If you answer “a lion,” you will be seen as aggressive. What type of personality would it take to get the job done? What impression do you want to make?

Source:  Monster.co.uk

20:20 Selection in On Target Publication

Healthcare recruitment consultancy 20:20 Selection Ltd is expanding with new premises and two new staff members.

Managing Director Karen Forshaw commented: “We have always considered it essential that the working environment should add value to our core function of recruiting for the pharmaceutical and medical industry. In our new location we are better prepared to address the challenges ahead.”

Managing Director Karen Forshaw commented: “We have always considered it essential that the working environment should add value to our core function of recruiting for the pharmaceutical and medical industry. In our new location we are better prepared to address the challenges ahead.”

New Recruitment Consultant Sarah Taylor has worked in the Sales and Marketing department of a private hospital, and has recruitment experience from earlier roles. She said: “20:20 Selection Ltd is a leading player in a fast-paced industry, with a unique team ethos focused on delighting the customer. It was these key features that attracted me to the company and I am delighted to be part of its success story.”

Sarah Byrom joins as Recruitment Administrator, having previously been a Recruitment Assistant for a computer game company. “Working in recruitment requires efficient and effective administration support,” she said. “I understand the importance of a slick programme which ultimately benefits our most important asset, the customer.”

Source: On Target

http://www.ontargetmag.com/article.aspx?issueID=140&articleID=1065

New Service at 2020 Selection

2009 sees the introduction of WebCam technology at 20:20 Selection Ltd making interviewing and coaching more convenient for you!

Our new building offers many sophisticated facilities such as a state of the art Conference and  Meeting room complete with an interaction video link from which clients can communicate and maximise their busy working schedules.

We feel the benefits of video link is endless, it offers clients in the field, the opportunity to attend important board meetings in real time, and allows prospective candidates the opportunity of having  direct dialogue with our consultants when they are unable to travel to our offices for interview.

Contact us on 0845 026 2020 to learn more about how we coach our candidates and the latest vacancies in the medical industry.