Escalation and documentation

Good documentation is crucial. When a patient cannot be managed in the pharmacy, the next clinician needs clear information. 

This may include the presenting complaint, duration of symptoms, relevant medical history, current medicines, allergies, observations, red flags considered and the reason the pharmacy service was not suitable.

A structured communication tool such as SBAR – Situation, Background, Assessment and Recommendation – can help keep messages concise.

Pharmacy technicians may help gather non-diagnostic information, prepare referral templates, ensure contact details are correct and check that messages have been sent using the agreed process.

Escalation routes should be agreed before the service goes live. The team should know what to do if a patient becomes unwell in the pharmacy, if safeguarding concerns arise, if the GP practice cannot be contacted or if the patient needs urgent assessment.

Pharmacy technicians should be trained in the process and be familiar with the relevant SOP. Most importantly, they should know when to involve the pharmacist immediately.

Practical actions

Pharmacy technicians can take several practical steps:

• Know which services your pharmacy provides and when they are available
• Understand who checks referrals and how quickly this should happen
• Agree standard patient explanations so the whole team gives consistent messages
• Use checklists for room readiness, equipment, stock and IT access
• Support clear documentation and safe handover when a patient needs onward referral.

As pharmacist prescribing becomes more common, pharmacy technicians should ask practical questions during team briefings, such as:

• What conditions can our pharmacist prescriber manage?
• What is outside the agreed scope of the service?
• How do we handle walk-in patients compared with those who are referred?
• What records are needed?
• How do we communicate with the GP practice?

These questions help turn a service specification (for instance, for prescribing) into safe daily practice.

A key opportunity is to consider how local pharmacies can work together to improve patient access. If appointment slots at one pharmacy are taken, the team should know how to identify other local providers that may be able to see the patient before simply signposting them back to general practice.