Southampton Academy of Research

Dr Andy Fox is a Consultant Pharmacist for Medicine Safety at University Hospital Southampton and holder of a Research Leaders Programme (RLP) fellowship.

He is interested in how information on electronic prescribing can be used to improve medicines safety, particularly for children.

Developing UHS pharmacy research

Andy has a clinical background as a paediatric pharmacist, but has long had an interest in research. In 2018, he completed his PhD at the University of Portsmouth, where he investigated electronic prescribing and paediatric medicines safety.

Since joining UHS, he has continued his research in this area, and now leads the development of the pharmacy department’s research. Taking on this role also enabled him to achieve consultant status.

“We had a desire to improve the research capability of the pharmacy department,” he explains, “and I was successful in getting a lead role for research in the department.”

Now, he’s looking to use his RLP fellowship to drive further development of the department’s research. This means he’s not only looking to develop his own research career, but to create a team of researchers at UHS who he can work with.

“This research leadership fellowship was an opportunity to set aside some time for me not only to develop my own research career,” says Andy, “but also to develop the research capacity, quality and capability of the pharmacy department more broadly.”

He plans to work with other RLP fellows in this cohort. He hopes that, together, they can change the mindset of others in the pharmacy department and prove research is a worthwhile endeavour.

“I’m looking forward to some formal leadership training, particularly as it’s aligned with research,” he says. “I’m also looking forward to engaging with my colleagues on the programme, as there’s a network there, so we can talk through our problems and learn about what everyone else is doing.”

Creating a UK-wide medicines safety network

Studies suggest that errors occur in around eight percent of all medicine prescriptions for hospital patients. For children in secondary care, this is even higher, with 13 percent of prescriptions. While most of these errors do no harm, reducing them would help to keep patients safe.

Most GP practices and around 60 percent of hospitals now use electronic prescribing. This generates new information that could be used to reduce prescribing errors and keep patients safe.

For example, the system might show that a doctor prescribed a medicine for one patient, only to retract that a few minutes later and then prescribe the same drug to a different patient. This would suggest they selected the wrong patient, known as a ‘mis-selection error’, but then corrected it.

Data on mis-selection errors could be used in various ways. Alerts could be set up for the pharmacist, so they could quickly identify the problem, discuss it with the doctor and resolve it before any harm came to the patient.

If lots of mis-selection errors were found to occur, it might be possible to test out changes in the system, such as adding a patient photo, that could help reduce them. You could also learn what cues enable a doctor to correct the error, and put in place changes which allow others to do the same.

One of Andy’s main goals for his fellowship is to create a Paediatric Medicines Research Safety Network, bringing together researchers from across the UK.

“What I’m intending to do is to drive some improvement in the way electronic prescribing is used within paediatrics,” he explains. “I hope, by doing this, I can reduce medication errors in children and so reduce any harm caused by them.”

While he’s already aware of ‘pockets’ of work going on across the UK, he says there’s a need to pull these all together. He then aims to find out where the knowledge gaps are and fill them.

“I love the idea of developing ideas and being creative, of using stuff that’s been happening in one place and applying it elsewhere,” he says. “I find that incredibly rewarding as a thing to do.”