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Rituximab is a potent monoclonal antibody against B lymphocytes; life-threatening Hepatitis B reactivation is well described following use and screening for hepatitis B before initiation is recommended. Neither the British Society of Rheumatology guidelines or the BNF explicitly specify Hepatitis B core antibody (anti-HBc) checks, although positive serology should be referred to a specialist for monitoring/initiation of antiviral therapy before Rituximab treatment.The role of pharmacy technicians contributing to patient safety and clinical audit is often overlooked; this audit demonstrates the important role pharmacy technicians can play in undertaking such work leading to a change in clinical practice.The techician used the trust wide pharmacy dispensing system (Ascribe) to create a list of all patients dispensed Rituximab between 1st May 2024- 31st October 2024. Clinic letters, microbiology results and pharmacy dispensing records were used to determine Rituximab start dates, pre-dispensing serology, antiviral medication and patient outcomes. A sample of 100 patients was used to validate microbiology datasets with manual case record review for planned real-time monitoring.In the 6-month period, 487 patients received Rituximab across 5 specialities (table 1). Of these 54% of patients had been tested for anti-HBc (46% were tested for both anti-HBc and HBsAg). Six patients were anti-HBc positive, of which only 3 had been referred to the Hepatitis team for consideration of antiviral medication prior to treatment. The 3 patients identified as anti-HBc positive but not referred, were highlighted to the specialty who subsequently referred to hepatology; all were subsequently initiated on Tenofovir.The primary clinician was informed for all 234 patients that had not had any hepatitis B serology performed to date. Blood chemistry review of this cohort did not identify abnormalities in liver function to suggest hepatitis B reactivation.We identified that one speciality had a very low number of anti-HBc tests; it was later discovered that this was due to incorrect information in the local SOP that has subsequently been rectified.This audit demonstrates the valuable role of the pharmacy technician in monitoring compliance with safe prescribing practice across a large organisation, using digital tools to streamline both the identification of patients and microbiology cross checking and enabling on-going prospective monitoring of patients.Abstract P125 Table 1Summary of the HBV serology undertaken in patients receiving rituximabHepatitis B screening completed Patients tested Patients tested before ritixumab Anti-HBc and HBsAg checked 250 (52%) 222 (46%) HBsAg checked only 231 (47%) 223 (46%) Anti-HBc checked only 2 (0.4%) 0 (0%) Testing rates by specialty Haematology n=192 Renal n=28 Paediatric Renal n=24 Neurology n=13 Rheumatology n=230 Anti-HBc 186 (97%) 28 (100%) 12 (50%) 11 (85%) 25 (11%) HBsAg 189 (98%) 26 (93%) 23 (96%) 13 (100%) 229 (99.6%)