Pharmacy environment

Think about the environment of the pharmacy and how you can make it easier for people with sight loss, for example:

• consider bright colour contrasted lines on the floor and colour-contrasted guide rails to help navigate to the pharmacy counter and consultation room
• ensure no chairs or other obstacles are blocking the way
• position signs on doorways and at the pharmacy counters (for example ‘IN’ and ‘OUT’ hatches) at eye level to enable close-up viewing.

Guide dogs

Guide dogs are working dogs, do not interact with them without first asking permission from the owner.

Communication

It is important that the pharmacy team ask people with sight loss about their preferences and communicate with them in the way that is easiest for them.

Consider the following points:

• a person with sight loss may not recognise your uniform or badge so it can be helpful to state who you are and what you will be doing
• when taking in a prescription, tell the person their prescription number
• ask if they prefer to have their name and number called out rather than reading a visual display
• allow extra time for them to respond to their call when their prescription is ready
• always speak directly to the person with sight loss, unless they tell you they prefer otherwise (for example, a carer).

Giving information about medicines

Accessing information about medicines can be challenging for people with sight loss. While it is not always possible to have all options immediately available to support people with sight loss, the following tips are generally applicable:

• ask the person how it would be easiest for them to access information about their medicines
• proactively consider what you can do in your pharmacy to make information more accessible, for example large print labels, braille, leaflets, screen readers
• make a record of their personalised requirements on the patient record system.

Managing medicines to support self-administration

Discuss with the person with sight loss how you can support them with self-administration and managing their medicines. The options below are generally available in most pharmacies.

Dispensing

Ask the person whether they would like any of the following, where appropriate:

• a non-child resistant cap for medicines containers
• halving tablets, if appropriate
• reconstitution of medicines if required (where normally supplied for reconstitution at home)
• if reconstituting medicines at home, ask how the person would find it easiest to identify the container, for example with coloured pen or a dispensing flag
• medication compliance aids, for example, easy grip bottle openers, aids for eye drops and inhalers, with or without braille.

Labelling

Ask the person whether they would like any of the following:

• printing the dispensing label in large font
• sending the dispensing label wording or additional information by email for screen reading
• providing a personalised dosing schedule chart in an accessible format

Large size labels

Guidance from the Royal National Institute of Blind People (RNIB) suggest using Arial font no smaller than 14. Ideally labels with black bold text on a yellow background are easiest for people with visual impairment to read. Community pharmacy dispensing systems can be used to create large text labels and system providers can demonstrate how to use this functionality. A freely accessible service from Translabel, can produce large-print labels, including in other languages. Labels are for use in addition to standard labels as they do not include all the text required by law.

Flagging labels

Using large text may require use of multiple labels which can obscure important details on medicine containers. Flagged labels, available from pharmacy label suppliers, enable larger amounts of information or larger text without obscuring product text.

Braille medication labels

The Reizen-RL 350 Braille Labeller is available from the RNIB shop. This is a labelling machine for producing braille labels. No knowledge of braille is required. Braille labels should not be placed over medication labels.

Differentiating containers

Support people with sight loss in identifying different or specific medicines, such as those with special storage conditions or short expiry. The following suggestions can be used, depending on the person’s needs and preferences:

• marking the medication container with a large sign or colour
• adding a dispensing flag to identify fridge storage requirements
• using different coloured highlighter pens to differentiate the different types of medicines
• tying two rubber bands around the medicines to be taken twice a day, or a long rubber band with three knots in it around the medicines to be taken three times a day
• using paper clips, dispensing flags, adhesive tape ‘flags’, ribbons, string, different coloured or textured stickers.

Patient Information Leaflets (PIL)

A service to support people with sight loss is provided by X-PIL at the electronic medicines compendium, which ensures that updated PILs are accessible to all people, including those with sight loss.

There is a telephone number where people can listen to or request patient information leaflets (PILs):

• in large and clear print
• in braille
• on audio CD.

This service is available 24 hours a day, 7 days a week and the caller will need to know the following information:

• the name of the medicine
• the medicine’s product code number.

Further Information

Useful resources available to help you provide services to patients with sight loss.

NHS England

NHS Accessible Information Standard covers NHS related pharmacy work and ensures disabled people receive easily accessible information and support, and provides a telephone contact point for members of the public with queries.

Health professionals with queries can email england.nhs.participation@nhs.net

RNIB

Royal National Institute of Blind People (RNIB) can be contacted for general advice and support for those providing services to someone who is blind or partially sighted, people with sight loss, or those who know someone with sight loss.

Moorfields Eye Hospital

The pharmacy team at Moorfields Eye Hospital have created an initiative to promote and encourage good eye drop adherence and provide support to patients, carers and staff regarding best techniques for administering eye drops.

Find out more and watch the Moorfields Eye Hospital’s Know Your Drops video.

General Pharmaceutical Council

The GPhC have guidance on why it’s important to avoid braille obstruction on medicine packaging.

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