Pharmacists are crucial in the role of modern healthcare, extending far beyond the supply of medicines. As experts in medicines, pharmacists are pivotal in ensuring treatments are safe, effective and appropriate for the individual concerned.
What is The Role of a Pharmacist?
Medicine optimisation is core to the role of the pharmacist to ensure that patients receive the right medication, at the right dose for the right duration with appropriate monitoring. Pharmacists use their clinical knowledge, national guidance and professional standards when assessing the suitability of medicines, especially when the patient has multiple conditions with complex regimes. Pharmacists act as a vital safety net before medicines are supplied to patients. It is important to identify potential errors in prescribing or interactions with other medicines to minimise the risk of harm to a patient. Alongside this, pharmacists ensure the right medicines are supplied in a timely manner and identify when patients are prescribed medicines but are not receiving or taking them.
In long-term care, pharmacists are involved in medication reviews to optimise care, minimise adverse incidents and improve patient outcomes. As patients get older this becomes even more important as medication regimes often become more complex, sometimes leading to medicines which don’ work well together, causing additional adverse effects.
How Can a Pharmacist Work Improve Community Health?
In community pharmacy, pharmacists now treat patients with acute, self-limiting conditions such as a sore throat, urinary tract infection, and impetigo through the NHS commissioned Pharmacy First service. Now allowing pharmacists to prescribe the contraceptive pill along with supplying Emergency Hormonal Contraception – the morning after pill – when required. They are also an integral part of the annual flu and covid vaccination programmes with a significant number of patients now choosing to access their local community pharmacy for their seasonal vaccination.
The role of the pharmacist is ever expanding, becoming more complex, and integral to local communities. From 2026, all graduating pharmacists will also be Independent Prescribers (IP) which will add to the existing post-graduate qualified IPs already working in pharmacy. This will facilitate a further expansion of the role into managing more complex acute conditions, whilst also looking to provide long-term conditions management.
The Role of the Pharmacist as an Expert Witness in Medico-Legal Cases
Medication related harm is a common cause of patient injury in healthcare. This could be caused by the wrong medication being prescribed or supplied, the wrong dose being taken, medicines not mixing well, or as simple as the medication not being available or taken by the patient. Whatever the cause, understanding how the harm arose is complex and requires an experienced pharmacist expert witness to unpick the errors.
Pharmacists can analyse medication errors throughout the patient journey, from the moment it is prescribed, through the dispensing process and, ultimately, ending up with the patient administration and ongoing monitoring. Pharmacists training and professional standards centres around medicines optimisation and safety is central to this in-depth understanding.
What Errors Can a Pharmacist Expert Witness Spot?
Prescribing errors continue to cause significant harm to patient; however, they are far more complex than often thought.
They can include:
- Selection of the wrong medication during prescribing or dispensing
- Incorrect dose regime or formulation
- Potential interactions with other medicines
- Existing patient allergies
- Not stopping medicines when no longer required
- Failing to prescribe medicines required by a patient
Dispensing errors are often assumed to just relate to the supply of the wrong medicine, however, it can be far broader than that with the reality including:
- Supplying the incorrect medicine or strength
- Incorrect dose regime or formulation
- Labelling errors
- Failure to supply all or part of a medicine
- Delays to time critical medicines
- Failure to identify critical medication interactions
An expert witness pharmacist can assess the entire medication journey and consider whether the decision taken were reasonable when compared to national guidance and the prescriber or dispenser’s professional responsibility. Importantly, this must consider what a reasonable healthcare professional would have known at the time without considering hindsight. The harm caused by not supplying required medicines is often overlooked, as an omitted anticoagulant, antiepileptic, insulin or antibiotic may result in a deterioration of the patient’s condition. Missing a required medicine may lead to relapse, withdrawal or deterioration of the patient’s condition.
A pharmacist expert is able to reconstruct the supply process and determine whether the correct checks were in place and whether the standard of care was that expected of a pharmacy professional.
How do Inappropriate Medicines Cause Medicine-Related Harm?
As well as discrete errors, harm can also be caused by the long-term inappropriate use of medicines, especially those liable to abuse. This may include:
- Long-term prescribing without clinical review
- High-risk medicines without adequate monitoring
- Multiple medicines only considered in isolation
- Continuation of medicines even with emerging side effects
Pharmacists are experts in medicines optimisation and deprescribing and therefore instructing a pharmacist allows a robust, evidence-based assessment of whether the ongoing management of medicines met the appropriate standards.
Why Instruct an Expert Witness Pharmacist?
Pharmacists are particularly valuable when the case spans multiple professionals and can help clarify where failures occurred and how they contributed to patient harm.
They bring the following expertise to a medico-legal case:
- Deep knowledge of medicines, the regulations, guideline and professional standards
- Understanding of real-world prescribing and supply of medicines
- The ability to decipher complex medication regimes
- Expertise in understanding the link between complex medication regimes and the causes of harm
- Clarity in explaining technical concepts in accessible manner
Harm caused by medicines is rarely simple. Whether it is the incorrect medicine, or a missing supply, harm can be caused. Pharmacist expert witnesses provide an essential insight into how medicines should be used and what can happen when it goes wrong.
Instructing a pharmacist as an expert ensures cases where medicines are involved are examined with the depth, accuracy and professional understanding required to support a fair outcome for the patient and clarity to the court.
If you would like to instruct Dr Richard Brown, please get in touch with our dedicated enquiries team at enquiries@mlas.co.uk, or click the link here to view his profile and CV here.