Pharmacists are up in arms over DH supervision plans


Nearly 500 pharmacists* have signed an open letter to the Royal Pharmaceutical Society calling on the professional body to oppose the idea of pharmacy technicians being legally allowed to supervise medicine sales.

Two community pharmacists, Mike Hewitson and Ben Merriman, wrote to the Society calling on RPS presidency candidates to come out against plans they say are being considered by the Department of Health’s rebalancing board to allow technicians to supervise pharmacies. The letter pulled no punches, saying it would be a “betrayal” if the RPS did not robustly oppose such a move.

The new RPS president will be elected at a meeting of its assembly on July 18 and is appointed as an ex-officio member of the rebalancing board.

The board, chaired by Ken Jarrold, was set up in 2013 to rebalance medicines legislation and pharmacy regulation by addressing areas such as decriminalising dispensing errors and pharmacy supervision. Allowing pharmacy technicians to legally supervise the sale of medicines is believed to be one of the options under consideration.

In the letter published on July 10, the two contractors state that many community pharmacists are “extremely concerned” about DH plans to empower pharmacy technicians to supervise pharmacies.

They say: “This simply cannot be allowed to happen as the public will be left without access to the knowledge and skills of the pharmacist. Anything other than a strong and robust opposition to these proposals by the RPS, its staff and elected officials will be seen as a betrayal by the thousands of community pharmacists in membership of the organisation and more than 2 million members of the public who signed a petition in support of community pharmacies and the service they provide.

“A pharmacy without a pharmacist is just a shop. This is a situation which cannot be allowed to occur, especially in England where the Government has already begun to deprofessionalise and depersonalise the supply of medicines and face to face advice which we know is so important to the public.”

The authors go on to say that many community pharmacists are “disillusioned” with the RPS, which they feel has put the development of new roles for a relatively small number of pharmacists ahead of the needs of the vast majority of the profession.

“Pharmacists in [GP practices] are no substitute for the on-demand provision of professional care and advice [in community pharmacies]. In recent years the RPS has placed too much emphasis on this emerging role. Our professional body must stand up for community pharmacists and their patients.”

Mr Hewitson told Pharmacy Magazine: “Like most community pharmacists we believe that you cannot dispense with the knowledge and expertise of pharmacists. Technicians and support staff have their role, but they should not be seen as an opportunity to run pharmacies ‘on the cheap’.

“Whoever is chosen as RPS president will be a member of the rebalancing board, along with the chief executive. We felt it was time to remind them of their duty to represent members: employees, locums and pharmacy contractors. Nearly 650 pharmacists have now signed our letter and have asked us to hold our elected representatives to account. We will do that with all means at our disposal.”

RPS responds

In response, the RPS said it has always believed that a community pharmacy requires a pharmacist to be present and it will not shy away from asking for investment in community pharmacy.

Its support for new roles for pharmacists in settings such as care homes, A&E and GP practices has helped integrate community pharmacy into the wider NHS, the Society argued. “These new roles have led to greater referral for MURs and the NMS in England and DMRs in Wales as well as improving the professional relationships between GPs, social care and community pharmacists.” 

The Society said it has listened to its members and “they have told us now more than ever [that] the sector should be coming together around a positive, constructive agenda that makes it clear how community pharmacy will be an integral part of the reformed NHS structures.”

Warning from president

In a blog published on the NPA website on July 13, RPS president Martin Astbury warned that if a pharmacist is not present in a pharmacy, then the support staff will come under pressure to act outside of their competency and the ethos that the public can walk in and get competent advice will be a thing of the past.

“Take away the highly trained healthcare professional and you might as well be in a garage or a shop. Pharmacists must on behalf of the public remain legally responsible for the over-arching supervision of the safe sale and supply of medicines. Give this function to anyone else and policymakers will have downgraded a vital function of the NHS.”

Technicians’ view

The Association of Pharmacy Technicians UK said it supports changes to supervision and greater delegation of tasks to pharmacy technicians as registered professionals within the pharmacy team. However, it believes that within any proposed changes “the presence of the pharmacist remains, along with overall accountability for the clinical appropriateness of medicines for patients”.

The role of pharmacy technicians is pivotal to the future of pharmacy services as pharmacists’ clinical role continues to evolve, it said.

 

* Update: 638 people had signed an accompanying online petition by July 14.

 

DH programme [rebalancing] board terms of reference

1. Examine the scope of legislation and regulation, and the interface between them, with a view to ensuring these are optimally designed to provide safety for users of pharmacy services, while facilitating a systematic approach to quality in pharmacy and responsible development of practice and innovation, whilst reducing the burden of unnecessary and inflexible regulations.

2. Address in parallel medicines and professional regulatory matters (e.g. supervision), which are considered to restrict full use of the skills of registered pharmacists and registered pharmacy technicians, impede the deployment of modern technologies and put disproportionate or unnecessary obstacles in the way of new models of service delivery by and/or involving pharmacy.

 

Technicians should not be seen as an opportunity to run pharmacies ‘on the cheap’

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