OAG PRESS RELEASE_Pharmacy - 16 Nov 2021
The report “HSA Outpatient Pharmacy Services” was issued today by the Office of the Auditor General (OAG).
Auditor General, Sue Winspear says “The Health Services Authority provides vital pharmacy services for a large proportion of the population, including many of our most vulnerable people.” Ms. Winspear continues, “It is pleasing, therefore, to be able to report that the HSA provides a good quality pharmacy service and has processes in place to ensure that the quality, safety and efficacy of the medicines it uses and dispenses to patients.”
The report highlights that the HSA provides a good quality pharmacy service, which has improved over recent years, but it needs to do more, including regularly measuring and reporting on performance.
Ms. Winspear adds, “I encourage the HSA to continue to improve pharmacy service, by for example improving its facilities, and to regularly measure and report on a range of performance indicators. These should include measures that contribute to customer satisfaction such as waiting times.”
The report concludes that the procurement exercise started by the HSA in late 2019 for the supply of medicines had a number of deficiencies and was abandoned early in 2021.
“The HSA spends around $9 million a year buying medicines and it is important that it obtains value for money from this.” Ms. Winspear adds, “It was disappointing to note that lessons from the previous procurement exercise did not appear to have been learned. The procurement exercise that started in late 2019 was started far too late and took too long, leading to contracts, that were not providing value for money, being extended multiple times. That procurement exercise was eventually abandoned in early 2021 and a new one has now started.”
The report states that the legislative framework is outdated and there is a lack of strategic direction at the national level for healthcare, and by extension pharmacy services.
The Auditor General says “Not for the first time I am having to report that the legislative framework for pharmacy services is significantly out of date and there is a lack of strategic direction at the national level for healthcare. The Pharmacy Act, which dates back to 1979, is not in line with current good practice and creates risks for the control and regulation of drugs that are able to be brought into the Cayman Islands. This needs to be rectified as soon as possible.”
More information about the report can be obtained by contacting Sue Winspear at (345) 938-3201 or Angela Cullen, Deputy Auditor General (Performance Audit) at (345) 244-3220.
The report can also be found at www.auditorgeneral.gov.ky.
Notes to the editor:
1. The Health Services Authority (HSA) is a statutory authority established under the Health Services Authority Act (2018 Revision).
2. At the time of the audit, the HSA provided pharmacy services to outpatients from eight dispensaries located at:
· Cayman Islands Hospital main pharmacy
· Cayman Island Hospital GP pharmacy
· Smith Road Centre pharmacy (this location is currently closed for renovation)
· West Bay Health Centre pharmacy
· Bodden Town Health Centre pharmacy
· East End Health Centre pharmacy
· North Side Health Centre pharmacy
· Faith Hospital pharmacy.
3. In 2020, the HSA dispensed 613,336 prescriptions to outpatients; 560,034 of these were from the three pharmacies located in George Town (Exhibit 2, page 10).
4. The Ministry of Health and Wellness (Ministry of Health) is responsible for developing and setting national strategy and policies for health.
5. The Pharmacy Council was created under the Health Practice Act and regulates professional pharmacy practice in the Cayman Islands, including the HSA and private sector pharmacies.
6. The audit focused on outpatient pharmacy services. It does not cover HSA’s clinical or inpatient pharmacies.