Patient Consultation Ares provide a private space in which to conduct patient counselling activities. In this article Lara Marín, IPU Professional Services Pharmacist, outlines the requirements for such areas.
Pharmacies provide high-quality services that are focused to meet their patient’s healthcare needs, and to improve health outcomes. In 2011 the World Health Organization (WHO) in collaboration with the International Pharmaceutical Federation (FIP) published their Guidelines on Good Practice: Standards for quality of pharmacy services. These guidelines emphasise that pharmacists should ensure patient confidentiality at the point of dispensing medical products and when delivering patient care and services. Similarly, there will be times in which citizens may need to discuss their health needs in a more private setting, such as a Patient Consultation Area (PCA).
In Ireland, the Retail Pharmacy Businesses Regulations 2008 (S.I. No. 488 of 2008) requires pharmacies to have a separate designated area at the pharmacy in which the pharmacist and the patient and/or patient’s carer, can discuss healthcare matters. The Pharmaceutical Society of Ireland (PSI) has published Guidelines on Patient Consultation Areas in Retail Pharmacy Businesses to facilitate compliance with Regulation 4(3) of these Regulations. Pharmacy owners and those in governance roles should ensure that the pharmacy(ies) under their governance have in place a PCA that it is available at all times within the pharmacy. The pharmacy owner is responsible for ensuring there is a PCA in the pharmacy. The superintendent pharmacist is responsible for having robust procedures in place to ensure that the PCA is used appropriately, and in line with legislative requirements and guidance. The supervising pharmacist is responsible for the training on, and implementation of, those procedures.
The PCA should be clearly designated, and should have a sign in place to inform members of the public that the facility exists, and is available for their use, if required. This area should not be used as a storage facility, and should not be the only access route to other areas, for example a storeroom or toilets.
The PSI guidelines outline the minimum requirements PCAs should meet. Pharmacy owners should ensure that these requirements are met, and may choose to go beyond these minimum requirements in the interest of delivering a high-quality service.
The primary purpose of the PCA is to provide a private space in which to facilitate patient counselling and to discuss health matters and medicines therapy to ensure patients are aware of the appropriate use and storage of medicinal products. Ideally, the PCA should be located close to the dispensary and the non-prescription medicines area. This will facilitate and support patient-pharmacist interactions, which in turn will enhance the role of the pharmacist as a medicine expert.
The PCA should be accessible from the public pharmacy area and should be accessible for all patient profiles, including those with disabilities, for example wheelchair users. Sometimes PCAs have two entrance points; they are accessed from the public pharmacy area in line with guidance, and also from the pharmacy dispensary. In this case, the door that leads to the pharmacy dispensary should have a lock to restrict access to the dispensary.
Pay particular attention if your pharmacy uses display stands so they are not located near the entrance to the patient consultation area, as it may impede access to the PCA.
Patients’ and/or their carers’ privacy and dignity should be maintained when discussing healthcare matters. The PCA should not only provide aural, but also visual privacy. Therefore, if you have a PCA with a clear glass door or window, you may consider the installation of a blind or use of other means (for example privacy glazing), to ensure that the visual privacy of the area is met.
If the PCA is used to provide additional services such as vaccination services, then the PCA should be an enclosed area to ensure that the privacy and dignity of the patient are maintained.
The use of CCTV cameras is a common feature in pharmacy settings. If your pharmacy has a CCTV camera within the PCA, patients must be informed of the presence of visual recording devices within the area. Therefore, it is advisable to have a notice conspicuously displayed within the PCA informing patients that a CCTV camera is in place.
The PCA is part of a healthcare facility and therefore should be finished to a high standard. The equipment in place should facilitate the primary purpose of this area, which is counselling and discussing health matters. The PCA should be furnished with a worktop or table so the pharmacist and/or patient can utilise it as part of any consultation/service, for example so as medicines being discussed, or a blood pressure monitor, could be placed on the area. The area should also have at least two chairs, with the possibility of additional seating for the patient’s carer/guardian/chaperone.
If your pharmacy is using the PCA for the provision of additional services you may consider having additional equipment in the PCA to support this service. For example, if your pharmacy provides a vaccination service, you may consider:
The PSI Guidelines on the Premises Requirements of a Retail Pharmacy Business outline the standards of fixtures and fittings that should be in place in a pharmacy setting.
The PCA should be of sufficient space to allow the pharmacist, patient and/or their carer/guardian/chaperone to be seated, and for any additional equipment required to support the patient and pharmacist interaction.
If the PCA is used for the provision of additional services, those in governance should ensure that the area is of sufficient size to provide the service, including for the management of any adverse events that may arise on foot of the service. For example, if the pharmacy offers a medication administration service, the PCA must be of sufficient size to lay a patient in the recovery position if required, without having to remove the existing equipment in place at the PCA, and to maintain the privacy and dignity of the patient.
Consideration should be given to the safety of all those utilising the PCA, including patients, their carers and pharmacists, or pharmacy team members, providing care in this area. You may decide to have a chaperone policy, with the option to use a chaperone being something that is available to both patients and pharmacy staff, as necessary. The use of security features such as CCTV and panic buttons can also be utilised in line with the PSI guidelines.
The IPU Professional Services team is available to answer your queries and provide you with guidance in PCA matters. Please email us on pharmacists@ipu.ie, or call 01 493 6401.
References available on request.
Lara Marín
Professional Services Pharmacist, IPU
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